It was first instituted in 1770 by Landgrave Frederick II, in honour of and under the patronage of Saint Elizabeth of Hungary, an ancestor of the House of Hesse, and was intended to award auspicious merit.

[4] It reverted to a single-class order on 20 August 1851 when Elector Frederick William I founded the Wilhelmsorden, which was created from the latter three classes.

[7] With the death of Frederick William I with no legitimate heirs, the main line of the Electoral House of Hesse-Kassel became extinct, and the orders were subsequently abolished on 27 August 1875.

It was thereafter awarded to members of the Grand Ducal House and foreign royalty, as well as the high nobility.

[8] The knights wore this medal on a crimson ribbon, hanging from the right shoulder to the left hip, and also on the left breast an eight-pointed silver star embroidered with rays, in the center of which on a blue handle with the red background and silver embroidered motto.