A gold color metal and enamel device 1 1/8 inches (2.86 cm) in height overall consisting of a red cross bearing a white disc with an interlaced maroon eternal cross all between four gold five-pointed stars, with to blue fleurs-de-lis in the upper angles of the red cross, all above a maroon scroll from the extremities of the horizontal arms of the lower angles, around the base of the vertical arm, bearing the inscription "BEYOND THE ORDINARY" in gold letters.
Maroon and white are the colors of for the Army Medical Department. The red cross, symbol of humanitarian ideals, is used to express both personnel and procedures of the Hospital, and the eternal cross reflects steadfastness and cooperation, with the interlacings simulating the numerical designation of the organization. The disc simulates a wheel and relates to the mobility aspect of the unit's mission. The fleurs-de-lis refer to France and to the organization's participation in the St. Mihiel and Meuse-Argonne campaigns, World War I. The four stars are used to represent the Papua, New Guinea, Luzon and Leyte campaigns, World War II, with the blue referring to both the Presidential Unit Citation for Papua, and the Philippine Presidential Unit citation for the Philippine Island Campaign.
The distinctive unit insignia was originally approved for the 4th Surgical Hospital on 8 July 1969. It was redesignated for the 4th Combat Support Hospital on 11 March 1974. The insignia was redesignated for the 4th Evacuation Hospital effective 16 March 1984.