The origins of Acambay date back to the settlement of the area by the Otomis who founded a ceremonial center called Huamango, which was occupied from 850 to 1350.

The nearby town of Benguitú, which was subsequently named Cabayé or Acambay was founded by the same tribe of Otomis soon after the abandonment of Huamango.

[1] The location of the Parroquia de San Miguel (Parish of Saint Michael) has been a church for the town since the 17th century; however, nothing of the original structure remains.

Aside from the town church, the Otomi Ceremonial Center is without a doubt the most important venue in Acambay; it is influenced by Mexica and Toltec prehispanic cultures.

The municipality covers an area of 492.13 square kilometres (190.01 sq mi), representing 2.21% of the state's territory.

[4] There are 8,100 speakers of Otomi and Náhuatl, most of whom are located in ethnic communities outside the municipal seat, representing only 30% of the total population.

[1] Of the total population residing in the town, 2.04% receive medical services by the IMSS, 27.73% from ISSSTE and 3.92% by ISSEMYM.