The Air Force Distinguished Service Medal was designed by Frank Alston of the Institute of Heraldry. The sunburst design is one of the most striking examples of the medalist's art and is a radical departure from the designs used in the Distinguished Service Medals of the other services.

The obverse design has a sunburst of thirteen gold rays separated by thirteen white enameled stars, with a semiprecious blue stone in the center. The reverse of the medal is plain and suitable for engraving. The star is suspended from the ribbon by a wide slotted bar which consists of stylized wings symbolic of the Air Force. The ribbon has a wide center stripe of white flanked on either side by a thin stripe of old gold, a wide stripe of ultramarine blue and a narrow strip of old gold at the edges. The blue stone in the center represents the vault of the heavens; the thirteen stars represent the original colonies and man's chain of achievements. The sunburst represents the glory that accompanies great achievements, and the rays depict man's quest for light and knowledge. Authorized devices to be worn with this include Oak Leaf Cluster and Combat “C” Device.