Created in 1984, the medal is intended to recognize individuals—both Canadian and foreign—who have carried out meritorious acts bringing benefit and honour in either of two categories: military and civilian.

[1][2] The Meritorious Service Cross, for both divisions, is in the form of a Greek cross with the arms 38 mm across, the ends splayed and rounded, a laurel wreath visible between them, and a St. Edward's Crown, as a symbol of the Canadian monarch's role as the fount of honour,[3] capping the top arm.

At the cross' centre, on the obverse, is a roundel bearing a maple leaf, and on the reverse are two concentric circles, the inner one containing an etched Royal Cypher of the reigning monarch, and the outer one engraved with the words MERITORIOUS SERVICE MÉRITOIRE.

For men, the cross is hung from a bar, and for women, on a ribbon bow, both pinned to the left chest.

[2] On 11 June 1984,[2] Queen Elizabeth II, on the advice of her Cabinet under Prime Minister Pierre Trudeau, created the Meritorious Service Cross to recognize highly professional acts that are of considerable benefit to the Canadian Forces; the civilian division was then added on 6 June 1991 (though applicable retroactively to 1984), honouring similar acts—whether in athletics, diplomatic relations, humanitarian activities, etc.—that benefit the nation.