A Silver color metal and enamel device 1 1/8 inches (2.86 cm) in height consisting of a shield blazoned: Gules (Sanguine), on a saltire Argent, a fillet saltire of the field, overall on a cross couped of the second voided of the first, a key palewise Silver. Attached above from a wreath Argent and Gules (Maroon) an alligator statant Proper. Attached below the shield a Silver scroll inscribed "PRO ARMIS" in Maroon letters.
Sanguine and white are used for Medical organizations. The saltire was suggested by the Florida State flag. The cross refers to the unit's mission, the key alluding to Miami, headquarters of the organization, and the "Florida Keys," southern Florida being the home area. The crest is that of the Florida Army National Guard. The motto translates to "In Support of Arms."
The distinctive unit insignia was originally approved for the 202d Medical Battalion on 10 May 1955. It was redesignated for the 35th Surgical Hospital on 26 November 1968.