The US state has had big floods, with at least three dead and 12 missing.
Images from Mexico showed cars and buildings badly damaged.
Many people have been injured and there are fears the death toll could rise.
The Coahuila Governor Ruben Moreira, on a visit to the stricken area, said 10 adults and three children had died and a baby was missing. Another 150 people had been taken to hospital, he said.
The authorities say that more than 1,000 homes have been damaged by the storm.
At one point the tornado reached a speed of 270-300km/h (168-186mph). Most of those who died were walking on the street when it struck, officials said.
The missing baby's child carrier was ripped from its mother's hands by a sudden gust of wind, Coahuila state Interior Secretary Victor Zamora said.
Ciudad Acuna Mayor Evaristo Lenin Perez said that it was the first tornado to hit Acuna since the city's foundation, more than 100 years ago.
Rescuers were searching the 750 damaged properties for more casualties.
"There are cars on top of houses, there are dead people lying in the street, it is total chaos," said local resident Maria del Rosario Ramirez, quoted by Mexican newspaper La Jornada.
The tornado only lasted a short moment but that was enough to devastate a community. It struck at a busy time in the morning - people were driving or taking public transport to work. Cars were catapulted towards buildings, roofs ripped off and many vehicles left upended.
Residents of Ciudad Acuna are used to hearing about this sort of thing north of the border in Texas, not experiencing this first-hand.
The infrastructure clearly wasn't strong enough to stand up to the impact - the army is helping to search for missing people and neighbouring states have also said they will lend a hand in the rescue effort.
He said the government would "take stock of the damage and provide all appropriate support".
Victor Zamora, Coahuila's interior secretary, said an area of about seven blocks had been "devastated" by the tornado, which struck at about 06:10 (11:10 GMT).
Civil protection officials said that eight temporary shelters had been set up for those made homeless by the disaster
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