[7] He later transferred to Bechem United as the Northern Irish club was unable to sign him, due to work permit issues, despite travelling with Christopher Forsythe to Belfast to train with the first team.

[9] On 1 February 2010, Palermo signed Acquah from Ghanaian club D.C. United Agogo for free,[10] but €500,000 agent fee went to SCMG Sport Consulting & Management GmbH.

[12] After choosing the number 94 shirt,[4] Acquah made his Palermo debut, coming on as a substitute for Giulio Migliaccio in the 32nd minute, in a 4–2 loss against Fiorentina on 13 February 2011.

[17] In January 2013 moved to German Bundesliga club Hoffenheim for €2.5 million fee on a four-year deal [15][18] but he was not given any opportunity to play a single match until the end of the 2012–13 season.

[19] In July 2013, he returned to Parma on a season-long loan deal and won his place back, finishing 27 league appearances in the 2013–14 season.

[29] On 22 June 2021, Acquah signed a two-year deal with Saudi Arabian club Al Batin FC as a free agent after his contract with Yeni Malatyaspor expired.

[37] He went to the Africa Cup of Nations in 2015 Equatorial Guinea, where Ghana reached the final and lost to the Ivory Coast 9–8 on penalties after a 0–0 draw.

A strong, talented and tenacious player, Acquah usually plays as a defensive midfielder in front of the defence, due to his pace, physicality, stamina and abilities as a ball-winner.