The award was established through Law ΓΡΣΗ/30-4-1913, as an order rather than a simple medal, but was not formally issued until the Royal Decree of 21 March 1921 (ΦΕΚ 47Α’/23-3-1921).

Given the great scarcity of actual medals, however, as well as the political upheavals of the 1920s, many common soldiers – in contrast to most officers – probably never received their awards.

It established the Medal for Gallantry, a new award exclusively for battlefield bravery, ranking above the Cross of Valour, but otherwise repeated the provisions of previous decrees relative to the latter, except that the medal was to be awarded solely for bravery on the battlefield, and no longer for leadership or military merit.

[13] The design of the badge was specified as a "crowned cross, bearing in the middle of the obverse side, in a circle of narrow laurel leaves, the image of St. Demetrios, while on the middle of the reverse side in a similar circle it bears the words ΑΞΙᾼ ("for valour" in Greek)".

[14][16] Repeat awards were designated with 5-millimeter miniature silver crowns, although a maximum of three was allowed to be worn on the ribbon.

[16] The 1974 version was not finalized until the early 2000s, when a change in design was decided: the crown was replaced by the national emblem of Greece, and the image of St. Demetrios by that of the Virgin Mary.