The Assumption Church of the Makaryevo-Unzhensky Monastery is located in the northwest part of the monastery courtyard, next to the two-story building of the abbess's cells. To the north and west, the terrain sharply descends, forming a deep ravine that leads into the valley of the Unzha River. The southern and eastern sides of the church face a deep monastery courtyard, where the main cult structures are located.

The church was used as a hospital and is an elongated building with a series of rooms. From west to east, these are: a two-story hospital ward with an upper floor from the 19th century, single-story vestibules with a cylindrical vault, a single-story refectory with a groin vault, the church's square part covered by a groin vault, above which are two diminishing octagons with a dome on a brick drum, and a single-part apse with a conch vault.

The church was consecrated in 1732, but due to its remoteness from all-Russian centers, it has retained features of earlier architecture characteristic of the turn of the 17th and 18th centuries. In the refectory, square part, and apse, some frescoes from 1857 have partially survived.

Currently, the hospital ward houses the Makaryevo post office, and its windows were modified in the 19th century. The square part and apse have remained in their main parts, but the dome has been destroyed, the roof is almost non-existent, and the window and door openings have been altered. This part of the building is used as sheds. The refectory and vestibules are in ruins: the southern wall is almost destroyed, the vault of the refectory has partially collapsed, and the vault over the vestibules was replaced in the 19th century with a flat ceiling, which has also not survived. The northern wall is in better condition, but even here the window openings have been altered, an additional window has been added in the refectory, and a large opening has been made in the vestibules. The floors are covered with a layer of earth and brick rubble. The collapse of the vaults occurred in the early 1960s after the roof was destroyed. The condition of the church is so critical that further delay in its conservation may lead to complete loss. Meanwhile, its significance in the architectural ensemble and as a specimen of Russian architecture is very great.