Born to a wealthy Jewish family in Manhattan, New York City, Acker took her last name from her first husband, Robert Acker; though born as Karen, she was known as Kathy by her friends and family. She studied classics as an undergraduate at Brandeis University and aspired to write novels but moved to San Diego to further pursue her studies. Acker's first work appeared in print as part of the burgeoning New York literary underground of the mid-1970s. She claimed that her early writings were profoundly influenced by her experiences working for a few months as a stripper. She remained on the margins of the literary establishment, only being published by small presses until the mid-1980s, thus earning herself the epithet of literary terrorist. 1984 saw her first British publication, a novel called Blood and Guts in High School. From here on Acker produced a considerable body of novels, almost all still in print with Grove Press. She wrote pieces for a number of magazines and anthologies, and also had notable pieces printed in issues of RE/Search, Angel Exhaust and Rapid Eye. Towards the end of her life she had a measure of success in the conventional press...the Guardian newspaper published several of her articles, including an interview with the Spice Girls, which she submitted just a few months before her death.

Acker's formative influences were American poet and writer (the Black Mountain poets, especially Jackson Mac Low, Charles Olson, William S. Burroughs), and the Fluxus movement, as well as literary theory, especially the French feminists and Gilles Deleuze. In her work, she combined plagiarism, cut-up techniques, pornography, autobiography, persona and personal essay to confound expectations of what fiction should be. She acknowledged the performative function of language in drawing attention to the instability of female identity in male narrative and literary history (Don Quixote), created parallelism in characters and autobiographical personas and experimented with pronouns, upsetting conventional syntax.

In In Memoriam to Identity, Acker draws attention to popular analyses of Rimbaud's life and The Sound and the Fury, constructing or revealing social and literary identity. Though she was known in the literary world for creating a whole new style of feminist prose and for her transgressive fiction, she was also a punk and feminist icon for her devoted portrayals of subcultures, strong-willed women, and violence.

In April 1996 Acker was diagnosed with breast cancer and had a double mastectomy. In January 1997 she wrote about her loss of faith in conventional medicine in a Guardian article, "The Gift of Disease." In the article she explains that after unsuccessful surgery, which left her feeling physically mutilated and emotionally debilitated, she rejected the passivity of the patient in the medical mainstream and began to seek out the advice of nutritionists, acupuncturists, psychic healers, and Chinese herbalists. She found appealing the claim that instead of being an object of knowledge, as in Western medicine, the patient becomes a seer, a seeker of wisdom, that illness becomes the teacher and the patient the student. After pursuing several forms of alternative medicine in England and the United States, Acker died a year and a half later from complications of breast cancer in an alternative cancer clinic in Tijuana, Mexico. She died in Room 101, to which her friend Alan Moore quipped, "There's nothing that woman can't turn into a literary reference."

Born and raised in New York City, novelist, poet and performance artist Kathy Acker came to be closely associated with the punk movement of the 1970s and '80s that affected much of the culture in and around Manhattan. As an adult, however, she moved around quite a bit. She received her bachelor's degree from the University of California, San Diego in 1968; there she worked with David Antin and Jerome Rothenberg.

She did two years worth of post-graduate work at City University of New York but left before earning a degree. While still in New York she worked as a file clerk, secretary, stripper, and porn performer. During the 1970s she often moved back and forth between San Diego, San Francisco and New York.

She married twice, and though most of her relationships were with men, she was openly bisexual for at least part of her adult life. In 1979 she won the Pushcart Prize for her short story "New York City in 1979." During the early 1980s she lived in London, where she wrote several of her most critically acclaimed works. After returning to the United States in the late 1980s she worked as an adjunct professor at the San Francisco Art Institute for about six years and as a visiting professor at several universities, including the University of Idaho, the University of California, San Diego, University of California, Santa Barbara, the California Institute of Arts, and Roanoke College.

Acker’s controversial body of work borrows heavily from the experimental styles of William S. Burroughs and Marguerite Duras. She often used extreme forms of pastiche and even Burroughs’s cut-up technique, in which one cuts passages and sentences into several pieces and rearranges them somewhat randomly. Acker herself situated her writing within a post-nouveau roman European tradition. In her texts, she combines biographical elements, power, sex and violence. Indeed, critics often compare her writing to that of Alain Robbe-Grillet and Jean Genet. Critics have noticed links to Gertrude Stein and photographers Cindy Sherman and Sherrie Levine. Acker’s novels also exhibit a fascination with and an indebtedness to tattoos. Ylioppilaslehti-magazine: Brief in english She even dedicated Empire of the Senseless to her tattooist.

Although associated with generally well-respected artists, even Acker’s most recognized novels, Blood and Guts in High School, Great Expectations and Don Quixote receive mixed critical attention. Most critics acknowledge Acker’s skilled manipulation of plagiarized texts from writers as varied as Charles Dickens, Marcel Proust, and Marquis de Sade.

Feminist critics have also had strong responses both for and against Acker’s writing. While some praise her for exposing a misogynistic capitalist society that uses sexual domination as a key form of oppression, others argue that her extreme and frequent use of violent sexual imagery quickly becomes numbing and leads to the degrading objectification of women. Despite repeated criticisms, Acker maintained that in order to challenge the phallogocentric power structures of language, literature must not only experiment with syntax and style, but also give voice to the silenced subjects that common taboos marginalize. The inclusion of controversial topics such as abortion, rape, incest, terrorism, pornography, graphic violence, and feminism demonstrate that conviction.

Acker published her first book, Politics, in 1972. Although the collection of poems and essays did not garner much critical or public attention, it did establish her reputation within the New York punk scene. In 1973 she published her first novel The Childlike Life of the Black Tarantula: Some Lives of Murderesses under the pseudonym Black Tarantula. In 1974 she published her second novel, I Dreamt I Was a Nymphomaniac: Imagining.

In 1979 Acker finally received popular attention when she won a Pushcart Prize for her short story "New York City in 1979." She did not receive critical attention, however, until she published Great Expectations in 1982. The opening of Great Expectations is a clear re-writing of Charles Dickens’s classic of the same name. It features Acker’s usual subject matter, including a semi-autobiographical account of her mother’s suicide and the appropriation of several other texts, including Pierre Guyotat's violent and sexually explicit "Eden Eden Eden". That same year, Acker published a chapbook titled Hello, I’m Erica Jong.

Despite the increased recognition she got for Great Expectations, Blood and Guts in High School is often considered Acker’s breakthrough work. Published in 1984, it is one of her most extreme explorations of sexuality and violence. Borrowing from, among other texts, Nathaniel Hawthorne’s The Scarlet Letter, Blood and Guts details the experiences of Janey Smith, a sex addicted and pelvic-inflammatory-disease-ridden urbanite who is in love with a father who sells her into slavery. Many critics criticized it for being demeaning toward women, and Germany banned it completely. Acker published the German court judgment against Blood and Guts in High School in Hannibal Lecter, My Father.

In 1984 Acker published My Death My Life by Pier Paolo Pasolini and a year later published Algeria: A Series of Invocations because Nothing Else Works. In 1986 she published Don Quixote, another one of her more acclaimed novels. In Acker’s version of Miguel de Cervantes' classic, Don Quixote becomes a young woman obsessed with poststructuralist theory, taking it to a nihilistic extreme. Moreover, the Don's insanity that causes her to wander the streets of St. Petersburg & New York City was caused from having an abortion. She recognizes the world’s many lies and fakes, believes in nothing and regards identity as an internalized fictional construct. Marching around New York City and London with her dog St. Simeon, who serves as her Sancho Panza, Don Quixote attacks the sexist societies while simultaneously deflating feminist mythologies.

Acker published Empire of the Senseless in 1988 and considered it a turning point in her writing. While she still borrows from other texts, including Mark Twain’s The Adventures of Huckleberry Finn, the plagiarism is less obvious. However, one of Acker’s more controversial plagiarisms is from William Gibson’s 1984 text ‘'Neuromancer’' in which Acker equates code with the female body and its militaristic implications. The novel comes from the voices of two terrorists, Abhor, who is half human and half robot, and her lover Thivai. The story takes place in the decaying remnants of a post-revolutionary Paris. Like her other works, Empire of the Senseless includes graphic violence and sexuality. However, it turns toward concerns of language more than her previous works. In 1988 she also published Literal Madness: Three Novels which included three previously published works: Florida deconstructs and reduces John Huston’s 1948 film noir classic Key Largo into its base sexual politics, Kathy Goes to Haiti details a young woman’s relationship and sexual exploits while on vacation, and My Death My Life by Pier Paolo Pasolini provides a fictional autobiography of the Italian filmmaker in which he solves his own murder.

Between 1990 and 1993 Acker published four more books: In Memoriam to Identity (1990); Hannibal Lecter, My Father (1991); Portrait of an Eye: Three Novels (1992), also composed of already published works; and My Mother: Demonology (1992). Many critics complained that these later works became redundant and predictable, as Acker continued to explore the same taboos in a similar fashion. Her last novel, Pussy, King of the Pirates, published in 1996, showed signs of Acker’s broadening interests as it incorporates more humor, lighter fantasy and a consideration of Eastern texts and philosophy that was largely absent in her earlier works.

Acker's work has been acknowledged by a number of younger writers working in an experimental style, including Stewart Home, Barry Graham, Anna Joy Springer, Tribe 8 singer and writer Lynn Breedlove, Tamil novelist Charu Nivedita, Noah Cicero, Travis Jeppesen, and Salvador Plascencia. Kathleen Hanna of Bikini Kill and Kim Gordon, co-founder of Sonic Youth have also acknowledged her influence.

Three volumes of her non-fiction have been published and re-published since her death. In 2002 New York University (NYU) staged Discipline and Anarchy, a retrospective exhibition of her works, NYU > The Office of Public Affairs > Discipline and Anarchy: The Works of Kathy Acker while in 2008 London's Institute of Contemporary Arts held an evening of her films. Guardian Unlimited: Arts blog - books: Looking back at Kathy Acker Recently (2007) Amandla Publishing has re-published Acker's articles for the New Statesman from 1989 to 1991.