The Distinguished Service Cross is the second highest military award that can be given to a member of the United States Army (and previously, the United States Army Air Forces), for extreme gallantry and risk of life in actual combat with an armed enemy force. Actions that merit the Distinguished Service Cross must be of such a high degree that they are above those required for all other U.S. combat decorations but do not meet the criteria for the Medal of Honor.

The Distinguished Service Cross was first awarded during World War I. In addition, a number of awards were made for actions before World War I. In many cases, these were to soldiers who had received a Certificate of Merit for gallantry which, at the time, was the only other honor for gallantry the Army could award, or recommend a Medal of Honor. Others were belated recognition of actions in the Philippines, on the Mexican Border and during the Boxer Rebellion.

The Distinguished Service Cross is awarded to a person who, while serving in any capacity with the Army, distinguishes himself or herself by extraordinary heroism not justifying the award of a Medal of Honor; while engaged in an action against an enemy of the United States; while engaged in military operations involving conflict with an opposing/foreign force; or while serving with friendly foreign forces engaged in an armed conflict against an opposing Armed Force in which the United States is not a belligerent party. The act or acts of heroism must have been so notable and have involved risk of life so extraordinary as to set the individual apart from his or her comrades.

The Distinguished Service Cross was established by President Woodrow Wilson on January 2, 1918. General Pershing, Commander-in-Chief of the Expeditionary Forces in France, had recommended that recognition other than the Medal of Honor be authorized for the Armed Forces of the United States for valorous service rendered in like manner to that awarded by the European Armies. The request for establishment of the medal was forwarded from the Secretary of War to the President in a letter dated December 28, 1917. The Act of Congress establishing this award (193-65th Congress), dated July 9, 1918, is contained in 10 U.S.C. § 3742. The establishment of the Distinguished Service Cross was promulgated in War Department General Order No. 6, dated January 12, 1918.

The Distinguished Service Cross was originally designed by J. Andre Smith, an artist employed by the United States Army during World War I. The Distinguished Service Cross was first cast and manufactured by the United States Mint at Philadelphia, Pennsylvania. The die was cast from the approved design prepared by Captain Aymar E. Embury II, Engineers Officer Reserve Corps. Upon examination of the first medals struck at the Mint, it was considered advisable to make certain minor changes to add to the beauty and the attractiveness of the medal. Due to the importance of the time element involved in furnishing the decorations to General Pershing, one hundred of the medals were struck from the original design. These medals were furnished with the provision that these crosses be replaced when the supply of the second design was accomplished.