The Navy Expert Pistol Medal is the highest award an individual can receive for pistol qualification. Like the Expert Rifle Marksmanship medal, it was established in 1920 and today requires a marksman to excel with a 9mm pistol on a course typically consisting of three phases at different distances (3, 7, and 15 yards) using different hands and stances and, in some cases, within a time limit.  

Each area of the human-shaped target is worth a certain number of points, and a minimum passing score is 180. Marksmanship is earned from 180-203 points; Sharpshooter, 204-227; and Expert, 228 or higher. Expert qualification equals 41 hits out of 45 rounds on the target, with at least 25 hits within a ten-inch circle on the torso and six hits within a six-inch circle on the head.

The medal, designed by the U.S. Mint, consists of two gold discs, a smaller one embedded into the top of a larger one. The smaller disc is inscribed with an eagle clutching arrows in its talons. The larger has a boxed target in the center with "Expert Pistol Shot" inscribed above and "United States Navy" curved below. The back is blank for the inscription of the recipient's name. The medal hangs from a navy blue ribbon with narrow light green stripes near the edge.

During the Vietnam War, the establishment of the Navy Pistol Marksmanship ribbon added levels of marksmanship achievement. A bronze "S" device on the ribbon denotes "Sharpshooter," a bronze "Expert" denotes a first and second "Expert," and a silver "E" signifies a third, final "Expert" rating. Today, these classifications have been streamlined, and personnel receive the silver “E” device for the Marksmanship ribbon the first time they score within the Expert range along with the Navy Expert Pistol Medal. Sharpshooters, on the other hand, receive a bronze “S” device with their Marksmanship ribbon, but no medal; those who qualify at the Marksman level rate only the ribbon.

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