The obverse bears likeness of Theodore Newton Vail. Above, THEODORE NEWTON VAIL; on left and right, MDCCCXLV / MCMXX. Around, 250TH ANNIVERSARY / 1697; signed at lower right of field, (JF monogram).

The reverse bears two nude male figres flanking clothed female figure. Around, THE VAIL MEDAL FOR NOTEWORTHY PUBLIC SERVICE; in exergue, AWARDED TO / DARWIN PAUL HOLTZMAN; signed on lower right (AW monogram).

The edge is marked 1114 - 1944.

Theodore Newton Vail (July 16, 1845 - April 16, 1920) was a U.S. telephone industrialist. He served as the president of American Telephone & Telegraph between 1885 and 1889, and again from 1907 to 1919. Vail saw telephone service as a public utility and moved to consolidate telephone networks under the Bell system. In 1913 he oversaw the Kingsbury Commitment that led to a more open system for connection.

The center figure represents the Service, the right Loyalty to Service and the left Devotion to Duty. The three figures are holding telephone cables. They are speeding the winged message over the wires.

This medal is most commonly encountered in bronze, but silver and gold versions exist as well. The bronze medals were awarded to individuals in each Bell company by that company's awards committee. A Bell Systems Committee then reviewed these cases and selected those of "especially outstanding excellenceor importance" for silver or gold medal awards. Bronze medals could also be awarded to groups of employees if the noteworthy act was a concerted group action. The depicted bronze medal was awarded to Darwin Paul Holtzman.

The medals measure 63mm (2.5in) in diameter and were manufactured first by Tiffany Co. of New York and later by the Medallic Art Company of New York.