We present and discuss initial selection criteria and first results in M33 from a systematic search for extragalactic symbiotic stars. We show that the presence of diffuse ionized gas (DIG) emission can significantly contaminate the spectra of symbiotic star candidates. This important effect forces upon us a more stringent working definition of an extragalactic symbiotic star. We report the first detections and spectroscopic characterization of 12 symbiotic binaries in M33. We found that four of our systems contain carbon-rich giants. In another two of them, the giant seems to be a Zr-enhanced MS star, while the remaining six objects host M-type giants. The high number ratio of C to M giants in these binaries is consistent with the low metallicity of M33. The spatial and radial velocity distributions of these new symbiotic binaries are consistent with a wide range of progenitor star ages.
