After the Medal of Honor and the respective services Distinguished Service Crosse's, the Defense DSM is the third highest decoration in the United States Armed Forces 'Pyramid of Honor'Medal riband fitted with 9mm crimp brooch with long-hinged pin & intricate drop-lock clasp fittings, as issuedThe mounting brooch with maker hallmark 'Graco-GI' indented on reverse of broochAmongst the most well known and recipients of this prestigious honour, there have been at least 14 x recipients of the DDSM with 4 x oakleaf clusters (there has also been a recipient with 6 x OLC's, and 3 x recipients of the DDSM with 5 x clasps). Amongst the recipients of the DDSM with 4 x OLC's, are included:- General David Petraeus- General Colin Powell- General John ShalikashvilliThe Defense Distinguished Service Medal (DDSM) is senior most decoration of the Department of Defense, awarded to members of the United States Armed Forces (all services and branches) while engaged in an exclusively 'Joint Service' capacityThe decoration while open to both commissioned and enlisted ranks, is in practise generally awarded to senior officers in the flag and general officer grades, followed by a lesser number of colonels and USN and USCG captains. The medal is presented in the name of the Secretary of Defense and was established by President Richard Nixon on, 9 July 1970, per Executive Order 11505. The award of the DDSM take precedence over all of the other service distinguished service medalsA choice exampleCondition: EF