Instituted: 30 March 2016 (Retroactive to 15 June 2014)
Criteria: must have been based in Iraq or Syria, fly missions over those countries, and/or serve in contiguous waters for 30 consecutive days or 60 nonconsecutive days. Service members who were killed or were medically evacuated from those countries due to wounds or injuries immediately qualify for the award, as do members who engaged in combat.
Devices: Bronze, Silver Star, Arrowhead, "FMF" Device
The medal's mailed fist and dagger represent "strength and courage in the defense of liberty and freedom". The scorpion being impaled was chosen because, the scorpion, symbolic for treachery and destruction, is found on most major land masses. The center of the ribbon is orange in color, surrounded by tan and blue, deriving its hues from the Ishtar Gate and the color of Southwestern Eurasian topography, which is primarily sand.