Background: Light-chain amyloidosis (AL) is a rare, multisystem disease with a varied presentation, and significant morbidity and mortality. Diagnostic delay can result in poor survival, particularly in patients with cardiac involvement. Aim: To understand the path to diagnosis for patients with AL using US-based claims data. Methods: We conducted a retrospective cohort study of adults (age ≥18 years) with AL using IQVIA PharMetrics Plus data (Jan 1, 2016-Sep 30, 2022). Patients with ≥2 AL diagnosis codes (index is date of second diagnosis; ICD-10: E85.81), ≥24 months’ continuous coverage pre-index, and ≥6 months follow-up were included. Results are reported using descriptive statistics. Results: A total of 1276 patients (58% male, mean age 62 years, 64% treatment naïve) met inclusion criteria at index. In the 2 years pre-index, patients saw the highest number of cardiologists (mean 4.1) compared with hematologist/oncologists (mean 1.8) and nephrologists (mean 1.7). Cardiovascular (CV) symptoms were experienced by 87% of patients within 2 years prior to index; 55% experienced their first CV symptom >1 year prior to index. 71% of patients with CV symptoms had features suggestive of renal involvement, eg, proteinuria. Almost a quarter (23%) of patients had at least 1 emergency room (ER) visit and a third (31%) had at least one inpatient hospitalization (IP) over the 6-month follow-up period. Over half of the ER visits and IP stays were due to CV-related symptoms. Among patients whose diagnosis of AL was delayed (with early onset of CV symptoms >1 year pre-index) compared with those who did not, the crude unadjusted odds of experiencing a CV related ER visit were 53% higher (OR 1.53, 95% CI: 1.09, 2.14; p=0.01). Conclusions: Cardiologists are a key part of the AL diagnostic pathway, as the most visited specialty prior to diagnosis. CV symptoms are the most common experienced by patients with AL and account for the largest proportion of IP stays and ER visits. Patients with delayed AL diagnosis from their first CV symptoms experienced significantly more CV-related ER visits than those without delayed diagnosis. Prompt diagnosis may help prevent a decline and the presence of heart failure symptoms with proteinuria or monoclonal gammopathy should raise suspicion of AL.