The Asiatic-Pacific Campaign Medal was established per Executive Order 9265, dated 6 November 1942, by President Franklin D. Roosevelt and announced in War Department Bulletin 56, 1942. The criteria was initially announced in Department of the Army (DA) Circular 1, dated 1 January 1943, so that the ribbon could be authorized prior to design of the medal. The criteria for the medal was announced in DA Circular 84, dated 25 March 1948, and subsequently published in Army Regulation 600-65, dated 22 September 1948.
The ribbon design was approved by the Secretary of War on 24 November 1942. The yellow ribbon has white and red on each side to represent the Japanese colors. The center blue, white, and red stripes are taken from the American Defense Service Medal ribbon and refers to the continuance of American Defense after Pearl Harbor.
The medal was designed by Mr. Thomas Hudson Jones. The reverse side was designed by Mr. A. A. Weinman and is the same design as used on the reverse of the European-African-Middle Eastern and American Campaign Medals. The medal design was submitted to the Commission of Fine Arts on 22 May 1947 and the first medal was presented to General of the Army Douglas MacArthur on 17 December 1947.
A bronze star is worn on the ribbon to indicate participation in designated campaigns. The designated campaigns for the Asiatic-Pacific Theater and inscriptions used on the Army Flag streamer set are:
- Philippine Island 7 Dec 41 - 10 May 42
- Burma, 1942 7 Dec 41 - 26 May 42
- Central Pacific 7 Dec 41 - 6 Dec 43
- East Indies 1 Jan 42 - 22 Jul 42
- India-Burma 2 Apr 42 - 28 Jan 45
- Air Offensive, Japan 17 Apr 42 - 2 Sep 45
- Aleutian Islands 3 Jun 42 - 24 Aug 43
- China Defensive 4 Jul 42 - 4 May 45
- Papua 23 Jul 42 - 23 Jan 43
- Guadalcanal 7 Aug 42 - 21 Feb 43
- New Guinea 24 Jan 43 - 31 Dec 44
- Northern Solomons 22 Feb 43 - 21 Nov 44
- Eastern Mandates 7 Dec 43 - 14 Jun 44
- Bismarck Archipelago 15 Dec 43 - 27 Nov 44
- Western Pacific 17 Apr 44 - 2 Sep 45
- Lyete 17 Oct 44 - 1 Jul 45
- Luzon 15 Dec 44 - 4 Jul 45
- Central Burma 29 Jan 45 - 15 Jul 45
- Southern Philippines 27 Feb 45 - 4 Jul 45
- Ryukyus 26 Mar 45 - 2 Jul 45
- China Offensive 5 May 45 - 2 Sep 45
- * Antisubmarine 7 Dec 41 - 2 Sep 45
- * Ground Combat: 7 Dec 41 - 2 Sep 45
- * Air Combat: 7 Dec 41 - 2 Sep 45
* These campaigns are not displayed as streamers on the Army flag.
A bronze arrowhead is worn on the ribbon to indicate participation in a combat parachute jump, combat glider landing, or amphibious assault landing within the Asiatic-Pacific Theater.