The Humanitarian Service Medal was established by President Ford per Executive Order 11965, dated 19 January 1977. The order provided for award for participation in a military operation of a humanitarian nature subsequent to 1 April 1975. The policy and award criteria for the Humanitarian Service Medal was established by Department of Defense Directive 1348.25, dated 23 June 1977.
Proposed medals were submitted to the Office of the Secretary of Defense (OSD) for approval 18 April 1977 and the selected design was approved by OSD on 10 May 1977. The design by Mr. Jay Morris, The Institute of Heraldry, uses the outstretched hand with palm up as the international symbol for aid and assistance. On the reverse, the oak sprig is symbolic of strength imparted through a selfless mission to aid mankind. The color purple in the ribbon stands for self-sacrifice, white for regeneration and blue for universal friendship. In addition, the two shades of blue are the colors used in the flags of OSD.
A bronze star is worn on the ribbon to indicate subsequent awards of the Humanitarian Service Medal.
Designated operations for which the Humanitarian Service Medal may be awarded are listed in DOD Manual 1348.33 (M).