Elaine Acworth studied at London's East 15 Acting School for several years, and subsequently worked for several small-scale theatre companies including Loose Change, whose brief was the exclusive production of new writing. Beginning as an actor with the ensemble, Acworth later attended directing workshops, and eventually turned to writing.
Acworth's first play, Torched, was produced by Finborough Theatre, London, in 1990. Returning to Australia the following year, Acworth became involved with the Queensland Theatre Company's (QTC) New Writing Programme, one result of this being her play Composing Venus. Commissioned by QTC and the Australia Council, the play won the 1993 George Landen Dann Award. Also in 1993, Acworth had her third work, Bod, a play set in Tibet, workshopped at the National Playwrights' Conference.
In 2018, Elaine Acworth received one of four Q ANZAC 100: Memories for a New Generation Fellowships at the Queensland Memory Awards, for 'Put Out into the Deep'.