A gold color metal and enamel device 1 1/8 inches (2.86 cm) in height overall consisting of a blue and gray embattled and quartered Greek cross on a white background bearing at center a gold Liberty Bell suspended from a brown wooden support, the crack and interior base of the Bell maroon, between two gold fleurs-de-lis and all surmounting the upper area of a continuous maroon scroll, the lower area curving upwards from the foot of the cross and behind the horizontal arms inscribed "KNOWLEDGE" "SKILL" "CARE" in gold letters.
Maroon and white are the colors used for medical organizations. The cross, a traditional symbol for aid and assistance, symbolizes the basic mission of the 108th Combat Support Hospital. The blue and gray embattled and quartered field of the cross is indicative of the War Between the States and alludes to the distinguished service credited the organization during that conflict. The fleurs-de-lis represent the World War I and World War II service in France while the colors yellow and blue refer to the Luxembourg Croix de Guerre awarded the unit. The Liberty Bell alludes to the city of Philadelphia, Pennsylvania, the home area and present location of the Combat Support Hospital.
The distinctive unit insignia was approved on 8 October 1976. It was cancelled effective 1 September 1997.