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Guido of Acqui, known in Italian as Guido d'Acqui and sometimes called Guy of Acqui in English sources, was bishop of Acqui in Piedmont, in northwestern Italy, during the eleventh century. Later tradition places his birth in Acqui itself around the beginning of that century, commonly given as about 1004, in a noble family identified as the Counts of Acquesana. Strictly contemporary evidence for his childhood is lacking. Local historical and hagiographical accounts state that he was educated at the Benedictine monastery of San Pietro in Acqui and that he was already noted for piety and learning before his elevation. In 1034 he became bishop of Acqui, a small but ancient see in the Ligurian-Piedmontese lands of the Kingdom of Italy within the Holy Roman Empire. He was a diocesan bishop rather than a member of a religious order after his consecration, and there is no historical evidence that he married or had children.

The diocese he inherited is described in later narratives as poor and poorly ordered. Guido is credited with applying his own family patrimony to the needs of the church. The work most firmly associated with his episcopate is the cathedral of Santa Maria Assunta, the duomo of Acqui, which local tradition holds was built or substantially completed under his direction and consecrated in 1067. He is also linked with the organization of the cathedral chapter and with efforts to raise clerical standards, in a period when demands for reform, including clerical celibacy and opposition to simony, were spreading through northern Italy in the decades around the accession of Pope Gregory VII. Surviving charters do not permit a full administrative history of his long tenure, but the cathedral remains the principal monument connected with his name.

Traditional lives of the saint dwell on charity. He is portrayed as a bishop who assisted the poor, widows, and orphans, and who used available resources for relief in times of want. Such stories follow a familiar pattern in medieval episcopal hagiography and cannot always be confirmed in detail from independent documents, yet they shaped his reputation in Acqui. He governed the see for some thirty-six years. Beyond the cathedral and the general portrait of a reforming and generous prelate, the secure outline of his career is limited; he is an important figure in the religious memory of one Piedmontese city rather than in the wider political history of the eleventh-century church.

Guido died in Acqui on 2 June 1070 and was buried in the cathedral he had promoted. Veneration at his tomb grew into a stable local cult. He was not the subject of a medieval papal canonization in the later juridical sense; his sanctity rested on diocesan custom. In 1853 Pope Pius IX confirmed the immemorial cult, an act that Catholic reference works treat as equivalent canonization for this pre-congregation saint. His feast is kept on 2 June. He is the patron saint of Acqui, today called Acqui Terme. Relics attributed to him are preserved in the cathedral of Santa Maria Assunta. Outside Piedmont he remains comparatively little known; within his own city he is remembered as the bishop who built the duomo and as a model of episcopal charity in the eleventh century.

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