Medal of Honor's concept, production and story were created by American film director and producer Steven Spielberg, who had a deep interest in World War II and found further inspiration from watching his son play GoldenEye 007.

The goal of the game is to complete various Office of Strategic Services (OSS) missions, such as rescuing an American pilot, going undercover to board and destroy a U-boat, recovering stolen art work, and sabotaging the Nazi war effort.

[7] Medal of Honor was a passion project that emerged during Spielberg's work on the film Saving Private Ryan, with development of the game beginning on November 11, 1997.

The idea originated from Spielberg's deep interest in World War II, while also watching his son Max playing the James Bond-themed game GoldenEye 007.

[8][9][10][11] According to game producer Peter Hirschmann, the studio's corporate management was worried that World War II was dated, and players were more interested in "ray guns, hell-spawn and laser rifles".

[7] Dye criticized their first demo as exploitative and irresponsible, but continued with the project due to his belief that the studio had honorable intentions, improving the game's historical authenticity with nostalgic and educational segments.

[7] The new demo was well received by publisher Electronic Arts, but was soon mired in controversy as the 1999 Columbine High School massacre attracted more scrutiny onto video games.

[16] IGN gave the game its editor's choice award, with reviewer Doug Perry praising its gameplay, sound, level design, attention to detail.