Acho attended St. Mark's School in Dallas, Texas. He had 12 sacks as a senior and 10 as a junior and was a team co-captain both years.
As a freshman in 2007, Acho played in 11 games, recording six tackles and a sack. As a sophomore in 2008, he recorded 15 tackles and three sacks. As a junior in 2009, Acho became a starter, starting all 14 games. He was an honorable mention All-Big 12 by The Associated Press after recording 55 tackles and eight sacks. Acho was the winner of the William V. Campbell Trophy (2010). This prestigious award is given to college football's top scholar-athlete. After the 2010 season, his teammates named him the MVP of the team.
Acho was selected by the Arizona Cardinals with the 103rd pick overall of the 2011 NFL Draft. In his rookie season as a Cardinal he made 40 tackles, 7 sacks and 4 forced fumbles.