A gold color metal and enamel device 1 1/8 inches (2.86 cm) in height overall consisting of a white disc charged with a scarlet saltire above a scarlet mound and centered overall a maroon cross with three crenellations on its upper arm, all within a circular maroon scroll with forked ends bearing at top the words "LEADERSHIP AND SERVICE" in gold, and issuant from each end toward center base a sprig of gold laurel leaves; overall a gold torch with flame centered upon the cross and handle between the leaves at center base.
The hometown and state of the unit are represented by four elements; namely, the scarlet saltire from the state flag of Alabama, the mound at the base of the cross which refers to Red Mountain where Birmingham is located, the flames of industry which light the skies of the city by night, and the encircling scroll representing a magic circle recalling the name, "Magic City," as Birmingham is sometimes described. The torch represents the leadership emphasized in the motto and its five flames the name, the numerical designation. The maroon cross representing medical service is embattled with three merlons which symbolize the World War II campaigns in which the unit participated, and the laurel leaves in base connote distinguished service.
The distinctive unit insignia was originally approved for the 5th medical Group on 24 November 1982. It was redesignated effective 16 September 2011, for the 5th Medical Brigade and amended to update the description and symbolism.