The Medal of Honor represented a military honor bestowed by the Galactic Empire for actions exceeding normal expectations in duty performance. Its general appearance mirrored that of the Medal of the Emperor's Fist. The Rebel Alliance also presented a comparable distinction, known as the Alliance Medal of Honor.
During 1 ABY, an Imperial-sympathizing spacer received this award, along with other pro-Imperial individuals, for their role in killing an Alliance general located on a Rebel Corellian corvette. Also that year, an Imperial ace pilot earned the Imperial Medal of Honor due to their participation in the destruction of the Rebel corvette named Radiant Anthem within the Kessel system.