Saposhnikovia divaricata is an authentic Chinese herbal medicine in Northeast China named Guanfangfeng, which is made from very high quality plants for sufficient efficacy. However, leaf spot causes a very large reduction in the yield and quality of S. divaricata in Shuangyashan (126°54′E, 45°81′N), Northeast China. A total of 18 isolates were isolated from the diseased leaves of S. divaricata, following Koch's postulates, and identified as Fusarium acuminatum based on morphological, molecular biological, and phylogenetic tree analyses. To the authors’ knowledge, this is the first report of F. acuminatum causing S. divaricata leaf spot in China. F. acuminatum infected perilla and mung beans, but not foxtail millet, peanuts, wheat, peas, rye, red beans, or sorghum. Susceptibility assessment of F. acuminatum to fungicides using the mycelial growth rate method showed that isolates of F. acuminatum were most sensitive to prochloraz, with EC50 values of 0.0005413-0.0009523 μg·ml–1. In the two field experiments, the average control efficacy of prochloraz at 0.450 g/l on S. divaricata leaf spot caused by F. acuminatum was 75.42%. Therefore, non-host plant rotation or intercropping with suitable chemical fungicides may be used to control S. divaricata leaf spot. This study’s results provide a theoretical basis for controlling S. divaricata leaf spot and will facilitate the development of effective disease management programs.