Background: Gynecologic cancer survivors (GCS) experience physical and emotional symptom burdens (SB) due to advanced, recurrent disease and intensive treatment often requiring supportive, complementary/integrative therapies. Yet, limited evidence exists on which specific SB require attention and intervention. This study aimed to identify demographics and SB of GCS referred for outpatient acupuncture services at a U.S. cancer center. Methods: A retrospective analysis was conducted of GCS actively receiving outpatient acupuncture services at the University of Chicago Supportive Oncology Program between March 2021 and June 2022. A brief self-reported SB assessment using a 0-10 Likert rating scale was completed at each acupuncture treatment. Socio-demographic (age, religion), disease information (stage) and SB (pain, insomnia) information was obtained from the medical record. Descriptive statistics were analyzed and paired sample t-tests evaluated SB differences prior to first and final treatment. Results: Eighty-three percent (54 of 65 referred) GCS received outpatient acupuncture care. Seventeen percent (11 of 65 referred) were unable to seek acupuncture due to disease progression leading to referral for end-of-life care (e.g. hospice, home palliative care). The mean age of GCS receiving acupuncture was 60y (range 30-81); 97% Non Hispanic, 65% White; 32% African American; 58% married; 53% with children; 65% Christian; 59% retired/on disability. Fifty percent of GCS had endometrial dx, 47% ovarian; 95% Stage IV; mean 7y since dx (range = .6-20y); 88% lacked advanced directives (e.g. DNR). Seventy percent completed at least four weekly acupuncture treatments. Prevalent SB were fatigue (94.1%), sleep disturbance (88.3%), pain (88.2%), anxiety (82.6%); and neuropathy (52.9%). On average, elevated SB mean scores were fatigue, numbness, anxiety, and hot flashes. Neuropathy was scored as the most severe (≥8 of 10). No significant improvement in SB was identified at the third treatment (p = 0.10). At the sixth session, GCS reported significantly less pain (p = 0.02). SB change was both statistically and clinically significant in 61-73% GCS at last session, except nausea. Only 0-5% of GCS reported worsening SB after acupuncture. Conclusions: Our results suggest acupuncture may aid in GCS SB control serving as a useful adjunct during cancer treatment and beyond. Early acupuncture referral may benefit GCS coping with SB during the cancer trajectory and is warranted. Future research should use a longitudinal prospective cohort design with validated SB measures.