A gold color metal and enamel device 1 1/8 inches (2.86 cm) in height overall consisting of a maroon stylized Japanese shelter, gold gable with incised lines, white openings, and bearing a red Greek cross surmounted by a maroon Greek cross, all in front of a gold circular background with radiating lines, all enclosed by a red circular scroll inscribed "ACHIEVEMENT IS OUR GOAL" in gold letters.
The stylized Japanese shelter with the openings of light and bearing a red Greek cross symbolizes the care, hope and knowledge offered by the Hospital while stationed overseas at Osaka, Japan. The red annulet circling the gold rays alludes to the collecting and evacuating capabilities of the Hospital. Maroon and white are colors used by the Medical Department.
The distinctive unit insignia was originally approved for the 86th Evacuation Hospital on 2 July 1970. It was redesignated on 20 April 1973, for the 86th Combat Support Hospital. Effective 16 March 1984, the insignia was redesignated for the 86th Evacuation Hospital. The insignia was redesignated for the 86th Combat Support Hospital effective 16 November 1993.