A silver color metal and enamel device 1 3/16 inches (3.02 cm) in height overall consisting of a guard lookout tower from Morro Castle in blue, bearing a white cross between two maroon fleams crossed beneath the tower at the finger loops, counter to one another with their blades outward and embattled of three all above a blue scroll perimetric on the lower portion from blade to blade of the fleams and inscribed "OUR MISSION OUR PRIDE" in silver.
Maroon and white (silver) are colors traditionally associated with the Medical Corps. Blue and white (silver) refer to the unit's history of medical support for the Infantry. The fleam is a heraldic symbol for a surgical lancet and denotes the former designation of the organization as a surgical hospital. The tower is from the historic Morro Castle and together with the embattlement, represents San Juan, the unit's home site. The cross symbolizes the humanitarian aspects of the unit's mission.
The distinctive unit insignia was originally approved for the 201st Surgical Hospital on 12 March 1969. It was redesignated for the 201st Combat Support Hospital on 17 June 1974. The insignia was redesignated for the 201st Evacuation Hospital with the description and symbolism revised effective 1 August 1983.