A gold color metal and enamel device 1 inch (2.54 cm) in width overall consisting of a green Greek cross bearing a gold vertical winged staff (caduceus), surmounted overall by a gold quadrate charged with a lion rampant of ten alternating horizontal bars, five white and five maroon, at the top a gold scroll (with ends folded back) inscribed "ACHIEVEMENT" and at the bottom a gold scroll (with ends folded back) inscribed "THROUGH SERVICE" all in red letters.
The lion rampant barry of ten is taken from the Arms of Hesse and represents the unit's World War II service at Bergheim, Bad Neuenahr and Hamborn all located in the province of Hesse, Germany. The winged staff (caduceus) a symbol of the medical profession also represents the speed and recovery record of the 135th Evacuation Hospital. The Greek cross is a symbol of mercy, while the green field represents the fields of Central Europe. The color green is symbolic of life and was also used for the ancient academic gowns for medicine. Maroon and white are colors used by the Medical Department.
The distinctive unit insignia was approved on 13 April 1970.