A gold color metal and enamel device 1 1/8 inches (2.86 cm) in height overall consisting of a five-pointed green star, point up, bearing in center a gold disc charged throughout with a maroon cross, and with a gold demi-fleur-de-lis issuing between each point.
The five fleurs-de-lis symbolize the unit's five World War II battle honors: Normandy, Northern France, Rhineland, Ardennes-Alsace and Central Europe. The five-pointed star alludes to the unit's original activation at Camp Bowie, Texas. The cross is a symbol of hospital units. Green, a color of health, was suggested by the flag of Italy and is used here to represent the historical record of the 45th Field Hospital at Leghorn, Italy. Maroon is a color used by the Army Medical Department.
The distinctive unit insignia was approved on 13 March 1969.