A gold color metal and enamel device 1 1/8 inches (2.86 cm) in height overall consisting of a white fleam, blade to base, in front of two diagonally crossed maroon lightning flashes, all in front of a maroon staff entwined with a gold serpent (Staff of Aesculapius), and all upon a gold eight-rayed sun, the top of the staff and serpent's head extending over the top rays; and in back of the rays encircling the top and sides of the sun a triple wavy band, blue between gold, terminating in a maroon scroll encircling the base and inscribed "WE MUST EXCEL" in gold letters.
Maroon and white are the colors used for the Army Medical Department. The organization's honors in World War II are commemorated by the eight-rayed sun for the Philippine Presidential Unit Citation, suggested by the Philippine Presidential coat of arms, and the wavy blue band on each side for the Asiatic-Pacific Campaign service. The unit's surgical mission is depicted by a fleam (the heraldic lancet), and the resuscitative medical treatment is indicated by the Staff of Aesculapius, the classic medical emblem. The lightning flashes refer to the swift, effective treatment provided by the Combat Support Hospital to prepare the critically injured and ill patients for extended evacuation. The "X" of the flashes, "L" of the lancet and "I" of the staff allude to the Roman number for the organization's numerical designation. Additionally, the combined "XL" creates a canting allusion (Excel) to the Hospital's motto.
The distinctive unit insignia was originally approved for the 41st Surgical Hospital on 23 April 1970. It was redesignated for the 41st Combat Support Hospital on 11 July 1972. The insignia was amended to revise the symbolism on 22 February 1973.