By late November 1942, the tide had turned for American forces on Guadalcanal. If Marine and Navy aircraft were not exerting air superiority, they at least had air parity. Navy ships were interrupting Japanese attempts to land additional forces ashore, and Soldiers and Leathernecks had begun arriving to reinforce the gaunt malaria-ridden Marines already there.
Lieutenant Colonel Merrill B. Twining, the operations officer of the 1st Marine Division, resolved to commemorate the Leathernecks' participation in the ill-conceived and poorly supported naval campaign. He thought an appropriate medal was required and turned to Captain Donald L. Dickson, a talented artist serving as the adjutant of the 5th Marines.
Who above Twining in the chain of command approved the medal, and its obvious criticism of the senior Navy officers involved in Operation Watchtower, is unknown. But when the division redeployed to Australia in early 1943, a local metal craftsman was hired to cast it.