Akerfelds graduated in 1980 from Columbine High School in Littleton, Colorado and played baseball at the University of Arkansas and Mesa State College. He was drafted by the Seattle Mariners in the first round with the seventh overall pick in the 1983 Major League Baseball Draft. Just over five months later, he was traded to Oakland, with whom he made his major league debut in 1986. He appeared in two games for the A’s before being traded to the Indians in July 1987. He spent much of the 1987 season in Cleveland, appearing in 16 games, 13 as a starter, with a win-loss record of 2-6 and a 6.75 ERA. After spending all of 1988 in the minor leagues, he was taken off the major league roster, then was selected in the rule 5 draft by the Texas Rangers.

After spending most of 1989 in the minor leagues once again, appearing in six games for the Rangers, Akerfelds was on the move again. This time, his contract was purchased from Texas by the Philadelphia Phillies. Akerfelds’ only full season in the majors came in 1990. He appeared in 71 games for the Phillies, all in relief. He had a 5-2 record with three saves and an ERA of 3.77.

Akerfelds started 1991 in the majors, but his ERA rose to 5.26, and he was returned to the minor leagues in July, where he was converted back into a starter. He started eleven games for the Scranton/Wilkes-Barre Red Barons, but his ERA rose to 6.32 at AAA. He was allowed to become a free agent after the season. After being signed by the Baltimore Orioles to start the 1992 season, Akerfelds spent another few seasons in the minors, finishing his career in the California Angels’ farm system in 1995 without returning to the majors.  After his retirement as a player, Akerfelds spent eleven years as bullpen coach for the San Diego Padres.  In 2011, Akerfelds was revealed to be suffering from pancreatic cancer. Akerfelds died in Phoenix, Arizona on June 24, 2012 from complications of the disease.