The medal was suspended from a crowned VR cypher attached to a brooch bar, backed with a Royal Stewart tartan ribbon.

His successor instituted the George V Long and Faithful Service Medal in May of 1913, twenty years after his marriage to Mary of Teck (which was the date when their Household had been independently established).

The Queen Elizabeth II Long and Faithful Service Medal was first issued in the year of her accession, 1952.

On versions of the medal instituted since King George V the obverse depicts the profile of the reigning monarch and the reverse has the inscription "FOR LONG AND FAITHFUL SERVICE".

[2] Notable recipients of the Royal Household Long and Faithful Service Medal include: