A silver color metal and enamel device 1 1/8 inches (2.86 cm) in height overall consisting of a maroon cross-crosslet fitchy with two silver serpents entwined around its lower vertical arm and all encircled by a blue scroll, arched at top, the ends curving inwards behind the horizontal arms, descending downwards and terminating around the embowed lower portion of the serpents and inscribed at the top "WE FIGHT FOR LIFE" in silver letters.
Maroon and white (silver) are the colors traditionally associated with the Medical Corps. The cross, a traditional symbol for aid and assistance, together with the serpents, attributes of Aesculapius, refers to the basic mission of the Hospital. The cross-crosslet fitchy is further a heraldic charge from the arms of Thomas West, Lord De La Warre, from whom the state of Delaware, home state of the hospital, derived its name.
The distinctive unit insignia was originally approved for the 116th Surgical Hospital on 20 May 1971. It was redesignated for the 116th Combat Support Hospital on 24 April 1974. The insignia was redesignated for the 116th Surgical Hospital with the description and symbolism revised effective 1 August 1984.