Background: The aim of this study was to compare the characteristics for genitourinary cancer (GUC) patients receiving specialized inpatient palliative care (SIPC) with those of a general cohort. Methods: We retrospectively evaluated 151 GUC patients receiving SIPC from 2008 to 2014 regarding symptoms, problems, treatment, and outcome. These characteristics were compared with a general cohort of 1,285 patients with various diseases who received SIPC (German Hospice and Palliative care investigation: HOPE). Results: Patients suffering from advanced prostate cancer (n = 59), renal cell cancer (n = 37), urothelial cancer (n = 36), urothelial accompanied by prostate cancer (n = 11), germ cell cancer (n = 7), and penile squamous cell cancer (n = 1) were included in the study. Most frequent symptoms and problems at admission were weakness (93%), the need for assistance with activities of daily living (85%), loss of appetite (81%), and organization of care (80%). Symptoms were more frequent in the GUC than in the general cohort during treatment, in particular with regards to pain (p < 0.001), tension (p < 0.001), nausea (p = 0.001), and vomiting (p < 0.001). GUC patients received significantly more opioids with 89% compared to the general cohort with 72% (p < 0.001). Conclusion: Symptom burden of GUC patients, in particular pain, tension, and nausea was higher compared to the general cohort, and analgesic treatment played an important role in achieving control of symptoms.