The DDSM shall only be awarded by the Secretary of Defense to officers of the Armed Forces of the United States whose exceptional performance of duty and contributions to national security or defense have been at the highest levels. Such officers have direct and ultimate responsibility for a major activity or program that significantly influences the policies of the US Government. Only under the most unusual circumstances will the DDSM be awarded as an impact award for outstanding TDY achievement. The DDSM is specifically intended to recognize exceptionally distinguished service and to honor an individual's accomplishments over a sustained period.

Normally, such broad responsibilities shall be held by only the most senior officers whose duties bring them into direct and frequent contact with the Secretary of Defense and the other senior officials within the Government. Examples of such positions are the Chairman of the Joint Chiefs of Staff; the Chiefs and the Vice Chiefs of the Military Services, including the Commandant and the Assistant Commandant of the Marine Corps; and the CINCs and the Deputy CINCs of the Unified Combatant Commands.

The DDSM also may be awarded to other senior officers who serve in positions of great responsibility, or to an officer whose direct and individual contributions to national security or defense are recognized as being so exceptional in scope and value as to be equivalent to contributions normally associated with positions encompassing broader responsibilities.

The pentagon refers to the five armed services, the Army, Marine Corps, Navy, Coast Guard (in time of war) and Air Force. It also alludes to the headquarters of the Department of Defense. The configuration of the eagle bearing the shield of the United States and grasping three arrows upon a medium blue background together with an arc of thirteen stars and wreath of laurel and olive refers to the seal of the Department of Defense and indicates the award of the medal in the name of the Secretary of Defense. The conjoined stars and gold rays signify unity and excellence in the performance of the mission of the Department of Defense on behalf of the Nation. Bluebird is the color associated with the Department Defense. Yellow signifies excellence and the knowledge and guidance provided by great achievement. Red connotes zeal and courageous action.