Military decorations for gallantry (especially those open to all ranks) did not gain popularity until the Nineteenth Century; before that they were largely limited to senior officers. The trend toward recognizing enlisted ranks began in 1802 when Napoleon Bonaparte created the Legion of Honor to reward distinguished service in both military and civil life. Although the Legion of Honor could be granted to all members of the military, it was given to privates and noncommissioned officers only under exceptional circumstances. To recognize "noncommissioned officers, corporals, privates or marines" in time of war, France created the Medaille Militaire in 1852. Following Napoleon's lead, Kaiser Friedrich Wilhelm III of Prussia created the Iron Cross in 1813 and made it available to all ranks. From its inception the Iron Cross was intended as a temporary award, only to be given during time of war when it would replace various other state decorations. The value of a senior combat decoration open to all ranks was also recognized by the British, who were frequently involved in military hostilities as they tried to maintain order in their far-flung empire. In the last year of the Crimean War (1853-1856) Queen Victoria established the Victoria Cross as the highest honor for combat heroism that could be conferred by the sovereign on any member of her armed forces. 

As military decorations and campaign medals proliferated in Europe during the Nineteenth Century, their popularity spread throughout the major armies. However, this trend was looked upon with disdain in the United States because military decorations were seen as being to closely related to orders of knighthood and other decorations associated with European royalty (which many of them resembled and by whom many of them were established). Moreover, the United States did not maintain a large standing army and had very limited experience in military operations outside its continental limits, thereby having little need for decorations. Even so, it was clear that some kind of award for gallantry had a place in the American armed forces. General George Washington created the Badge of Military Merit in 1782, stating that in so doing, "...the road to glory in a patriot army and a free country is thus opened to all." The Badge of Military Merit fell into disuse after the Revolutionary War and remained obsolete until 1932 when it was reestablished as the Purple Heart. 

The United States government did award Congressional rather than military medals, but they were quite different from those we know today. They were conferred by Congress to commemorate specific events or people and were not purely military decorations. In addition, their scope did not extend beyond the people or events they commemorated. This kind of medal is still awarded from time to time; the most recent being authorized by Congress include those for Generals Colin Powell and Norman Schwarzkopf for their leadership during "Desert Storm" in 1990-1991. 

The Civil War was one of the most significant events in American history. It altered many aspects of life in this country and its consequences can still be felt. When the United States entered the Civil War the Federal government did not have any military decorations, although some individual organizations and military units occasionally authorized their own awards for bravery, good conduct, long service, or proficiency in marksmanship. When the Civil War started both sides thought it would be brief, but before long both the Confederate and Federal governments realized the war was going to last much longer than first anticipated. Government leaders also recognized the need for rewarding personal gallantry, especially on the part of those soldiers and sailors whose valor was above and beyond the call of duty. The concept of military decorations, which had become firmly rooted in Europe, began to find acceptance in America. It was in this context that the Medal of Honor was born.