A loud rattle type noise may be noted from the engine after a cold start. This can be caused by a faulty valve timing control actuator. Replacing the failed actuator will commonly correct this noise issue.
Car problem reports
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Most reported 2010 Acura TSX problems
A faulty tire pressure sensor may cause illumination of the low tire warning light even if tire pressure are correct. If this condition occurs the affected sensor(s) should be replaced.
Some vehicles may develop a soft, low brake pedal. Our technicians tell us this condition may be caused by a faulty vehicle stability assist (VSA) modular control unit. If this is the case replacement of the VSA modular control unit would be required.
The rear brake pads wore out after 20k miles. There was still plenty of pad left on the front brakes, but it seems they designed the brakes with not enough meat on them for the rear. I've found other complaints of this issue from drivers oh the NHTSA site.
The hood may flutter or vibrate at freeway speeds. Acura has made a revised rear hood seal available which should eliminate this problem.