Although the United States Air Force was established as a separate and distinct branch of the U.S. military in 1947, its nearly thirty-year history as a component of the United States Army meant that many of the medals it awarded its personnel during the first few years of its existence were actually Army decorations. This changed with the introduction of the Air Force Outstanding Unit Award (AFOUA), established by Secretary of the Air Force Harold Talbott on January 6, 1954. It was the first independent Air Force decoration ever authorized, and for half-a-decade it was the highest-ranking USAF unit award.
The AFOUA is awarded to numbered units that have set themselves apart through exceptionally meritorious service or outstanding achievements that clearly distinguish them other, similar units. Examples of exceptional meritorious service or noteworthy achievements include accomplishing a singular outstanding feat that is of national or international prominence or significance; combat operations against an armed enemy of the U.S.; or military operations result in exposure to hostile actions by an opposing foreign force.
Although the AFOUA is typically awarded to numbered units down to the squadron level, as well as to numbered and unnumbered medical facilities such as hospitals, clinics, and medical centers, units that would otherwise not qualify because they are not numbered can be specifically included in the award given to their parent unit (but only if they are submitted and approved as an exception to policy). Alternately, regulations allow for them to be considered for the award on the basis of their own merit. All other unnumbered units at the squadron-level or higher must be submitted as a candidate for the Air Force Organization Excellence Award, the next lowest Air Force unit award in terms of medal precedence.