Bone marrow biopsy is an essential element in the diagnosis, classification and monitoring of hematological disorders, where it provides morphological and immunophenotypic information. Conventional grading is limited by interobserver variability and the inability to capture the full molecular and spatial complexity of the pathology. Multi-omic technologies such as genomics, epigenomics, transcriptomics, proteomics, lipidomics, metabolomics and microbiomics, along with artificial intelligence, are reshaping this assessment. They generate high-dimensional data that reveal molecular signatures of diseases, refine classification, improve risk stratification, and support therapeutic decision-making. AI-assisted image analysis increases objectivity and reproducibility when integrating morphological and molecular data from biopsy histology and aspirate cytology. Clinical translation of these advances is hampered by issues of standardization, cost, data integration, and regulatory validation. A mini-review summarizes applications of omics and artificial intelligence in bone marrow biopsy diagnostics and discusses the future of integrated precision hematology.