Per pale Gules and Azure, on a chief wavy Argent, a cross couped Sanguine, overall a torch entoured by a horseshoe reversed Silver, the torch enflamed Or.
From a wreath of the colors Argent and Sanguine, a mount Vert, thereon a mullet of the first, shaded Gris, charged at its center with a sunburst Or, between two sprigs of bluebonnet Proper.
ANSWERING THE CALL.
The triparted shield: Argent, Gules, and Azure, represents the Texas flag and the unit's home. The Sanguine (maroon) Medical Cross on an Argent (white) field is a traditional symbol of the Medical Corps and the activities of healing and caring. The wavy line on the chief symbolizes the amphibious nature of the 4th Engineer Special Brigade, which the 264th Medical Battalion was assigned to support during World War II. The torch represents the battalion's instructional mission as part of the U.S. Army Medical Department Center and School and the surrounding horseshoe represents the earliest horse-drawn ambulances.
The torse (a wreath of colors) Argent (white) and Sanguine (maroon) are traditional colors of the Medical Corps. The mullet (star) represents the Lone Star of Texas and is surmounted by a sunburst symbolizing the Philippine Unit Commendation in World War II. The sprigs of bluebonnets are another symbol of the unit's home of Texas and in conjunction with the Vert (green) alludes to the mission support of land-based soldiers.
The coat of arms was approved on 13 October 2006.