Background: Multimorbidity and depressive symptoms (DSs) are common in older adults. Self-rated health (SRH) allows detection of elderly adults with a high burden of multimorbidity plus depression. The aim of this study was to test the association of groups of multimorbidity and DS on SRH in Colombian older adults. Methods: We conducted a cross-sectional study in 2012 in Bogotá, Colombia, called “Salud, Bienestar y Envejecimiento” (Health, Well-being, and Aging), including 2000 community-dwelling adults 60 years of age or older. SRH was assessed with the question “How would you rate your health?” giving five possible answers. DSs were rated using the 15-question version of the geriatric depression scale, and multimorbidity was defined as having two or more chronic diseases. A logistic regression model was used to identify the association between grouped DS and multimorbidity with SRH. Results: Groups were distributed as follows: 678 with no DS/no multimorbidity (33.9%), 808 with only multimorbidity (40%), 128 with DS only (6.4%), and 386 with DS/multimorbidity (19.3%). An association of fair/poor SRH with DS/multimorbidity group was found (odds ratio 5.5; 95% confidence interval 3.86-7.95, p < 0.001) when compared to subjects without any of those conditions. Conclusion: There was an incremental association between DS and multimorbidity with SRH. An older adult referring to his or her own health with a negative connotation should alert to a higher burden of diseases, including DS.