A white rectangle with rounded corners 3 inches (7.62 cm) in height and 2 inches (5.08 cm) in width overall bearing a red saltire (Saint Andrew’s Cross), bordered in maroon.  Emitting from base is a red triangle with a narrow maroon border.  Centered on the saltire a maroon cross with three crenellations on its upper arm bearing a sword with a serpent coiled around it, all white; all within a 1/8 inch (.32 cm) maroon border.      

The crenellated cross symbolizes medical strength and defense.  The scarlet saltire (Cross of Saint Andrew) symbolizes the Brigade’s mission of supporting the medical requirements of Soldiers and their sacrifices on the battlefield. The red triangle alludes to the iron rich Red Mountain, under whose shadow the unit resides. The reference to the Staff of Ae culapius alludes to its attribute of the Roman god of medicine and healing.

The shoulder sleeve insignia was approved effective 16 September 2011. The insignia was amended to modify the symbolism on 6 April 2023. 

A gold color metal and enamel device 1 1/8 inches (2.86 cm) in height overall consisting of a white disc charged with a scarlet saltire above a scarlet mound and centered overall a maroon cross with three crenellations on its upper arm, all within a circular maroon scroll with forked ends bearing at top the words “LEADERSHIP AND SERVICE” in gold, and issuant from each end toward center base a sprig of gold laurel leaves; overall a gold torch with flame centered upon the cross and handle between the leaves at center base.   

The mission and location of the unit are represented by four elements; namely, the scarlet saltire (Cross of Saint Andrew) symbolizes the Brigade’s mission of supporting the medical requirements of Soldiers and their sacrifices on the battlefield. The mound at the base of the cross which refers to Red Mountain where Birmingham is located, the flames of industry which light the skies of the city by night, and the encircling scroll representing a magic circle recalling the name, “Magic City,” as Birmingham is sometimes described. The torch represents the leadership emphasized in the motto and its five flames the name, the numerical designation. The maroon cross representing medical service is embattled with three merlons which symbolize the World War II campaigns in which the unit participated, and the laurel leaves in base connote distinguished service.

The distinctive unit insignia was originally approved for the 5th medical Group on 24 November 1982.  It was redesignated effective 16 September 2011, for the 5th Medical Brigade and amended to update the description and symbolism. The insignia was amended to modify the symbolism on 6 April 2023.