The medal was instituted in 2002 to provide specific New Zealand recognition for operational service.

It is awarded in addition to any New Zealand, Commonwealth or foreign campaign medal.

Personnel and veterans who have been awarded a campaign medal for operational service since 3 September 1945 qualify for the award of the NZOSM, provided that the particular campaign medal has been approved for acceptance and wear by New Zealanders.

In addition, personnel who, under certain circumstances, have not completed the qualifying period for an approved campaign medal, but who have completed a specific period of service in an operational area towards such a medal (generally seven days on the posted strength of a qualifying unit), are eligible for the NZOSM.

To date, the NZOSM has been issued to over 19,000 veterans, currently serving military personnel and civilians.