In 1898, Åkerhielm published her first novel "Hvidehus", at the age of 29. The novel was influenced by Åkerhielm's anger over the Greco-Turkish War of 1897. It won the grand prize at "Idun" magazine's novel competition. Two more poetry collections followed in the next few years. She won the Mindre guldmedaljen award from the Swedish Academy for her verse novel "" (1900). In 1901, she published the novel "Ett främmande namn" which was inspired by her travel to Greece. She wrote nearly 50 other novels in the following years with her last novel "Katinka gör karriär", published in 1945.