A gold color metal and enamel device 1 3/16 inches (3.02 cm) in height overall consisting of a red (scarlet) cross with four equal arms on a green (Army green) field, encircled with five gold arrowheads with points outward and with bases touching, all in front of a maroon background enclosed within a ten-sided irregular border, below a gold scroll folded at each end and inscribed in black letters, "ALWAYS THE BEST."
The red cross on the green background is used to represent the 42d Field Hospital. The unit played a vital role during the Normandy invasion and throughout the remainder of World War II, in Europe; the five arrowheads symbolize the five battle honors for Normandy, Northern France, Rhineland, Ardennes-Alsace and Central Europe. The gold border of embattlements alludes to Fort Knox, Kentucky, the headquarters of the 42d Field Hospital and the location of the Federal Government's gold vault.
The distinctive unit insignia was approved on 15 January 1969.