The Navy, Marine, and Coast Guard, Medal of Honor
The first Medal of Honor was a five pointed inverted star with an anchor suspension. A ribbon of red and white verticals stripes, capped by a blue band, suspended the award from a pin clasp. In 1896, a newly-designed medal featured a blue ribbon with thirteen stars.

In 1913, the medal underwent another design change. The suspended anchor was altered by the removal of the rope design and the ribbon was changed to a light blue silk with thirteen white stars. This form, either as a medal or suspended from a blue neck ribbon remains in use.

In 1919, the Navy introduced a second type of Medal of Honor, the “Tiffany Cross” awarded for peace time valor. It features an upper clasp bar engraved with “VALOR” above the blue silk ribbon with thirteen stars. The medal is a Maltese Cross designed by Tiffany and Co. of New York. This award was discontinued in 1942.

The Army Medal of Honor
The basic five pointed inverted star design of the Navy Medal of Honor was used in the design of the Army award. Its suspension device was an eagle holding cross cannons. The 1862 ribbon design featured alternating red and white vehicle stripes with a horizontal blue stripe at the top. It was suspended from a decorative pin clasp.

The ribbon design was changed in 1896. The new silk ribbon had two broad red outer stripes, separated by two thin blue stripes with a center white stripe. The remainder of the design remained unchanged.

In 1904 the medal was altered to a central medallion, containing the head of the goddess of war, and an outer ring of green enameled oak and laurel leaves. The suspension device is an eagle holding the word “VALOR.” A blue silk ribbon with thirteen stars rises to a pin clasp. This award may be worn as a medal or suspended from a neck ribbon.

The Air Force Medal of Honor
The Air Force received authorization for an award in 1956, but would wait until the Vietnam War to present its first Medal of Honor. The Air Force medal was sculptured by Lewis J. King, Jr. of the Army's Institute of Heraldry. Like the other Medals of Honor, it is based on an inverted five-pointed gold plated star with ring of green oak and laurel leaves. The suspension device includes a bar with the word “VALOR” and a connector symbolizing the wings and lightning bolts of the Air Force crest.

Medal of Honor Flag

The issuance of a Medal of Honor flag to all future recipients of the medal was authorized in 2002. Its design was conceived by Bill Kendall of Jefferson, Iowa. Legislation was sponsored by Representative Tom Latham and Senator Chuck Grassley of Iowa. The design was formalized by Sarah LeClerc of the Army Institute of Heraldry.

The first Medal of Honor flag was presented to the family of SFC Paul R. Smith, of Tampa, Florida. He received the Medal of Honor (Posthumously) for his action on April 4, 2003 during “Operation Iraqi Freedom”