The town is situated in the Monferrato hills along the banks of the Bormida river, and is renowned for its amaretti cookies and the typical "baci" Acqui, the truffle and mushrooms, and the excellent Monferrato red wines. There is in the town one of the earliest spa industries of Italy, the Acqui S.p.A. The town offers fine thermal complexes which include mud baths and comfortable hotels, but also great wines and food, cultural and historical heritage, facilities for sports and hiking itineraries.
The hot springs of Acqui are some of the oldest in northern Italy: the ancient Ligurians had a settlement there, and the springs were famous in Roman times and in tremendous demand during the Middle Ages.
According to the legend, Acqui was founded by the Greeks with the name of Caristo, then it was conquered by the Romans in 172 BC. Ancient historians like Pliny, Strabo, Seneca, Tacitus already spoke of its thermal waters, called "Aquae Statieellae".
After the fall of the Roman empire in 476 AD it became a Dukedom under the Longobards. In the 11th century it was a member of the Lombard League against Frederick Barbarossa. In 1278 it was under the Marquis of Monferrato, in 1533 it came under the power of the Gonzaga from Mantua and finally came under the power of the the Savoy.