We investigated the characteristics and biological activities of vinegars added with different levels (0%, 0.5%, 1%, 2%, and 3%) of young leaves of Akebia quinata. During alcohol fermentation, alcohol and total acidity contents of vinegars increased. During acid fermentation, total acidity and amino acid contents increased. Vinegar added with 3% A. quinata leaf showed the highest total sensory score. The contents of total polyphenols, flavonoids, and tannin significantly increased during fermentation according to the amount of A. quinata leaf. After 22 days of fermentation, total polyphenol, total flavonoid, and tannin contents of vinegar added with 3% A. quinata were 4,079.08 mg GAE/100 g, 2,927.08 mg CE/100 g, and 3,618.00 mg TAE/100 g, respectively. ABTS radical scavenging activity of vinegar added with 3% A. quinata was 79.63%. Anti-cancer activities of vinegar added with 3% A. quinata were 48.65% and 52.90% against MCF-7 and HepG2 cells, respectively. Vinegar added with 3% A. quinata showed anti-bacterial activities against Bacillus cereus, Shigella flexneri, Salmonella enterica, Bacillus subtilis, and Klebsiella pneumoniae. Our results demonstrate that the biological activities of vinegar added with 3% A. quinata leaf (22 days of fermentation) were excellent, and their enhanced total polyphenol, flavonoid, and tannin contents were associated with antioxidant, anti-cancer and anti-microbial activities. Thus, A. quinata can be used as a functional material in vinegar and other foods.