Background: There are no studies on the use of psycho-oncological services by soft tissue sarcoma patients. The aim was to determine the frequency of use of psycho-oncological services in the hospital in this group and to investigate associated factors. Methods: The cohort study PROSa (burden of disease and care situation in sarcoma) was conducted between 2017 and 2020 in 39 German study centers. Cross-sectional data from adult soft tissue sarcoma patients were analyzed for the present analysis. Patient- as well as facility-level factors were explored as potential predictors of utilization using logistic regression in a generalized linear mixed model. Results: Among 910 participating patients, data were available from 576 (63.3%). In all, 212 patients (including the missing data 23.3%, without them 36.7%) made use of psycho-oncological services. Negatively associated with utilization were male sex (vs female; odds ratio [OR] 0.62) and older age (18–< 40 years vs 65–< 75 years: OR 0.32; 18–< 40 years vs ≥ 75 years: OR 0.19). Positively associated were educational level (high school diploma vs 8/9 years of schooling: OR 2.01) and grading (high-grade tumors vs low-grade: OR 4.41). When psycho-oncologists were involved in interdisciplinary tumor board, utilization increased (OR 6.69). Conclusion: Female sex, younger age, higher education, and advanced disease stage were positively associated with increased utilization. A structural factor for increased utilization was psycho-oncology involvement in the tumor board.