The Meritorious Service Medal is awarded to members of the Armed Forces of the United States who distinguished themselves by outstanding non-combat meritorious achievement or service to the United States subsequent to January 16, 1969. Normally, the acts or services rendered must be comparable to that required for the Legion of Merit but in a duty of lesser though considerable responsibility.

At the Tri-Department Awards Conference, February 5, 1968, there was a discussion on the need for a third meritorious award to provide appropriate recognition for non-combat achievement or service comparable to the Bronze Star Medal for combat achievement or service. It was felt that the Legion of Merit's prestige was slipping because it was being used with increasing frequency to reward service below the Legion of Merit's intended standard, but higher than that required for the Commendation Medal.

A proposed executive order was prepared in April 1968 and forwarded for approval to the Military Departments. An ad hoc committee was formed by the Secretary of Defense (M&RA) to select a name. On November 8, 1968, the committee unanimously approved the name "Meritorious Service Medal." President Lyndon Johnson established the Meritorious Service Medal per Executive Order No. 11448 dated January 16, 1969. The Executive Order was amended by President Ronald Reagan per Executive Order 12312, dated July 2, 1981, to authorize award to members of the armed forces of friendly foreign nations.

The decoration was designed by Mr. Jay Morris of the Institute of Heraldry, and the design was approved by the committee on March 20, 1969. The ribbon design purposely follows the colors used for the Legion of Merit to reflect the parallel between the two medals. The eagle, symbol of the United States, stands on laurel branches denoting achievement. The star is used to represent the military service and the rays emanating therefrom denote the constant efforts of individuals to achieve through excellent and meritorious service.

The Meritorious Service Medal is a bronze medal, 1.5 inches in diameter overall, consisting of six rays issuant from the upper three points of a five-pointed star with beveled edges and containing two smaller stars defined by incised outlines; in front of the lower part of the star an eagle with wings upraised standing upon two upward curving branches of laurel tied with a ribbon between the feet of the eagle. The reverse has the encircled inscriptions "UNITED STATES OF AMERICA" and "MERITORIOUS SERVICE". The ribbon is 1 3/8 inches wide and consists of the following stripes: 1/8 inch Crimson 67112; 1/4 inch White 67101; center 5/8 inch Crimson; 1/4 inch White; and 1/8 inch Crimson.

This medal is not the same as the Defense Meritorious Service Medal.