The award is a peacetime equivalent of Uttam Yuddh Seva Medal, which is a Wartime Distinguished Service decoration.

Since 1980 the awarding of the medal have been restricted to operational service as the Yudh Seva Medal was created to recognize distinguished services in an operational environment.

[3] The Ati Vishisht Seva Medal is made of silver gilt and has on its obverse a five-pointed star and on its reverse the Lion Capital.

The ribbon is gold in colour and is 32mm wide with two dark-blue stripes dividing it into three equal parts.

Additional awards of the Ati Vishisht Seva Medal are represented by a bar worn on the ribbon.