Despite lacking air support the division put up a surprisingly strong resistance, helping pause the Coalition advance and ultimately serving as one of the contributory factors for the halt order given by President George H. W. Bush on 28 February 1991.

The division, which was deployed 50 miles south of Baghdad, straddled a heavily fortified area known as the "Red Zone."

The division dispersed and embedded itself around Karbala, placing units close to homes, schools, mosques and the region's many ancient Shia shrines.

Medina Division forces were also one of the units believed to have been readying for using chemical weapons during the invasion.

[6] In the ensuing Battle of Kut, the division put up a surprisingly light resistance, with many Republican Guard forces choosing instead to desert.