Objective To identify the symptom management experiences and multidimensional needs of patients with myasthenia gravis based on patient journey mapping, to provide a basis for developing targeted symptom management interventions. Methods A descriptive qualitative study was designed. Sixteen patients with myasthenia gravis were selected using purposive sampling method to conduct semi-structured in-depth interviews. Directed content analysis was employed for theme extraction and analysis, and patient journey maps were subsequently developed. Results Four phases including screening and diagnosis, acute treatment, stable maintenance, and relapse transition were used as the temporal framework. Across three dimensions (tasks, emotions, and pain points), 27 themes related to symptom management were identified, consisting of difficulties in early symptom recognition, prolonged diagnostic pathways, and anxiety and suspicion related to an unknown etiology etc. A comprehensive patient journey map was subsequently developed. Conclusion The tasks, emotional experiences, and pain points associated with symptom management in patients with myasthenia gravis exhibit dynamic changes and distinct variations across different phases of the disease trajectory. Healthcare professionals should tailor precise and dynamic symptom management interventions to these phase-specific needs in order to alleviate symptom distress and enhance the overall quality of care.