Created in 1991, 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.

The Meritorious Service Medal, for both divisions, is in the form of a circular, silver disc with, on the obverse, a raised Greek cross, 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 beyond the circumference of the medal.

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

[2] On 6 June 1991,[2] Queen Elizabeth II, on the advice of her Cabinet under Prime Minister Brian Mulroney, created the Meritorious Service Medal to recognize highly professional acts that are of considerable benefit, to the Canadian Forces by military personnel, and to the nation by civilians.

As of August 2009, the Meritorious Service Medal has been presented to 568 people—279 in the military division and 289 in the civilian[5][6]—all of whom are permitted to use the post-nominal letters MSM.