On 5-6 February 1968, at the Tri-Department Awards Conference, a discourse was held regarding the necessity for another meritorious award that would give the proper acknowledgement for noncombat achievement or service equivalent to the Bronze Star Medal for combat achievement or service. It was thought that the Legion of Merit had been used much more often to honor service that was of a lesser standard than the Legion of Merit standard, yet greater than that necessary for the Commendation Medal.
In April 1968 a proposed executive order was ready and sent to the Military Departments for approval. A name was to be selected by an ad hoc committee created by the Secretary of Defense. The name "Meritorious Service Medal" was unanimously approved by the committee on 8 November 1968. Executive Order No. 11448 dated 16 January 1969, by President Johnson recognized the Meritorious Service Medal. President Reagan, per Executive Order 12312, dated 2 July 1981, amended the order to approve the awarding of the Meritorious Service Medal to award service members of armed forces of friendly foreign nations.
Mr. Jay Morris of The Institute of Heraldry designed the decoration that was approved on 20 March 1969 by the committee. The similar colors used for the ribbon design and the Legion of Merit accurately show the similarity between the two awards. An eagle, as a symbol of the nation, standing on laurel branches represents achievement. The star stands for military service, and the rays coming out from it symbolizes the continuous actions of persons to achieve through excellent and meritorious service.