A gold color metal and enamel device 1 1/8 inches (2.86 cm) in height overall consisting of a blue (ultramarine) background surmounted by a gold diamond shape of beveled rays radiating from the center and bearing a maroon Greek cross with the vertical arm charged with a white bar throughout, all between at top a red (scarlet) scroll folded back at the sides behind the diamond shape and inscribed "SERVICE" at the base a scroll of the like inscribed "BY HEALING" all in gold letters.

The cross, a symbol of aid and assistance represents the 2289th U.S. Army Hospital.  The diamond shape on the blue background was suggested by the State flag of Delaware and symbolizes the unit's location at Wilmington.  The single vertical stripe simulates the numeral "One" and refers to Delaware, the first state to ratify the U.S. Constitution.  The color white symbolizes knowledge, life and hope, all representative of the Hospital.  The gold rays allude to the healing rays of the sun and good health.  Maroon and white are colors used for the Army Medical Department.

The distinctive unit insignia was approved on 25 May 1971.