A gold color metal and enamel device 1 1/8 inches (2.86 cm) in height overall, consisting of a gold wing bearing a maroon cross charged with a gold bear's head caboshed. Attached below, a maroon scroll inscribed "FEAR NOT" in gold letters.
Maroon is the color traditionally associated with the Medical Corps. The cross, a symbol of the Medical Corps, is charged with a bear's head, representative of the place of activation of the unit, Camp White in Oregon, in the Crater Lake region, where black bears are seen. The gold eagle's wing denotes association with the air forces. The motto, "Fear Not," is expressive of the characteristics of the personnel in performance of their duties.
The distinctive unit insignia was originally approved for the 11th Field Hospital on 8 December 1942. It was rescinded on 19 July 1961. The insignia was reinstated and authorized for the 21st Evacuation Hospital on 29 January 1968. The distinctive unit insignia was redesignated effective 16 December 1992, for the 21st Combat Support Hospital, with description and symbolism revised.