Symptom burden is known to be high in patients with hematologic malignancies and can adversely impact patients' quality of life. The aims of this retrospective observational cohort study were to explore symptoms in patients with hematologic malignancies, including during the last year of life, to explore symptom profiles in patients with hematologic malignancies, and to explore associations among symptoms/symptom profiles and demographic, clinical, and treatment-related variables. Symptom prevalence and severity and symptom profiles were explored in patients with hematologic malignancies who completed patient-reported outcome measures (n = 6136) between October 2019 and April 2020. Emergency department visits and hospital admissions during the study period were reviewed. Chart audits were undertaken for patients who died within a year of completing patient-reported outcome measures (n = 432) to explore symptoms and healthcare utilization in the last year of life. Patients with hematologic malignancies in this study reported multiple symptoms co-occurring, with more than 50% of patients reporting four or more symptoms. Classes of co-occurring symptoms (symptom profiles) were associated with demographic and clinical factors as well as with healthcare utilization, particularly emergency department visits. The most reported symptoms were tiredness, impaired well-being, and drowsiness. The findings emphasize the need for more supports for patients with hematologic malignancies, particularly for symptom management.