A member of the Spinola family, Agostino Spinola was born in Genoa ca. 1482, the son of Giovanni Spinola, consignore of Garessio, and Petruccia Riario. He was a grand-nephew of Pope Sixtus IV. He was a cousin of Cardinal Raffaele Riario.
On December 19, 1509, he was elected Bishop of Perugia. He participated in the ninth through the twelfth sessions of the Fifth Council of the Lateran (1512–17). He accompanied Pope Leo X on his trip to Bologna.
Pope Clement VII made him a cardinal priest in the consistory of May 3, 1527. He received the red hat and the titular church of San Ciriaco alle Terme Diocleziane on August 3, 1527. He was the administrator of the see of Savona from July 17, 1528 until his death. He resigned the administration of Perugia in favor of his brother Carlo Spinola on February 15, 1529. He was the Camerlengo of the Sacred College of Cardinals from January 1, 1532 to January 8, 1533. On September 5, 1534, he opted for the titular church of Sant'Apollinare alle Terme Neroniane-Alessandrine.
He died in Rome on October 18, 1537. He was buried in the convent of San Domenico in Savona. When that church was demolished in 1544, the marble bas-relief of his tomb was placed in the Palazzo Pozzobonello-Del Carretto.
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