It was to be presented to a sailor or Marine who "in action involving actual conflict with the enemy, distinguish[es] himself conspicuously by gallantry and intrepidity at the risk of his life above and beyond the call of duty and without detriment to his mission.

The center, overlaying the cross, is an octagon with the phrases "UNITED STATES NAVY" to the top and "1917·1918" to the bottom, on the perimeter separated by two stars.

[2] On 4 February 1919, in the same act that created the Navy Cross and the Navy Distinguished Service Medal, Congress provided: That the President of the United States be, and is hereby authorized to present in the name of Congress, a Medal of Honor to any person who, while in the naval service of the United States, shall, in action involving actual conflict with the enemy, distinguish himself conspicuously by gallantry and intrepidity at the risk of his life above and beyond the call of duty and without detriment to the mission of his command or the command to which attached.

Despite the "actual conflict" guidelines, the Tiffany Cross was awarded to Floyd Bennett and Richard Byrd for arctic exploration, and to John Siegel for a rescue at sea.

[1] The US Naval History & Heritage Command asserts that 28 sailors and Marines received the Tiffany Cross, but does not provide a list.

[9] The Navy's assertion of 28 recipients is believed to be derived from the fact that 21 Sailors and 7 Marines were awarded the Medal of Honor for actions during World War I.