A gold color metal and enamel device 1 3/16 inches (3.02 cm) in height overall consisting of a maroon silhouette of a mission tower bearing within a maroon bell charged with a scarlet Greek cross against a white sky, in base an open wreath of gold palm branches above a horizontal gold scroll folded back at each end and inscribed "SERVE THE DEFENDER" in scarlet letters.
The mission bell bearing the cross, a symbol of aid and assistance, represents the predecessor unit which was located at Bell, California. The bell is typical of the belfries of old Spanish missions in the area and symbolizes service, strength and endurance. The gold palm branches symbolize good health and the healing rays of the sun. Maroon and white are colors used for the Army Medical Department.
The distinctive unit insignia was originally approved for the 349th General Hospital on 4 January 1972. It was redesignated effective 16 December 2004, for the 349th Combat Support Hospital.