Instituted by King Victor Emmanuel III of Italy on January 19, 1918. It was awarded to members of the Italian armed forces for meritorious service during wartime operations on land, sea, or in the air. The criteria for receiving the medal included a minimum of one year of service in contact with an enemy, receiving the Medal of the Wounded, or being mentioned in dispatches for war merit and receiving a field promotion.
The obverse of the cross features the inscription 'MERITO DI GVERRA' (War Merit) and the crowned royal cypher of Victor Emmanuel, while the reverse typically depicts a five-pointed star on a background of sun rays.