A silver color metal and enamel device 1 1/8 inches (2.86 cm) in height overall consisting of a silver winged staff on a cross divided horizontally wavy maroon above blue surmounting and between two black snakes nowed, erect and respectant, all above and within a maroon scroll arcing to base and inscribed "LEADING IN CARE" in silver letters.
Maroon and white are colors traditionally associated with medical organizations. The winged staff and serpents, attributes of Aesculapius, the God of Medicine and Healing, together with the cross for aid and assistance, represent the basic mission of the unit. The wavy blue alludes to the parent unit's service in the Rhineland during World War II. Also, the twin serpents with their double loops together with the vertical arm of the cross, simulate the numerical designation of the organization.
The distinctive unit insignia was originally approved for the 818th Hospital Center on 18 June 1979. It was redesignated for the 818th Medical Brigade with the description and symbolism revised effective 17 September 1992.