The Medal of Faithful Service () was instituted by King Carol I in April 1878.
The medal was worn until 1932 on a light blue ribbon with a yellow central stripe on the left side of the chest. From 1932, the award was presented on a light blue ribbon with a yellow central stripe and a silver edge stripe.
During the Second World War from 1941 to 1944, the medal with swords was also awarded to members of the German Wehrmacht.
In early 1948, together with the Order, Cross and all the traditional Romanian orders were disbanded by the communist authorities.
In 2000, it was re-instituted together with the Order and Cross, as a three class medal. It is the second most important award for people without higher education, the equivalent of the Order of Faithful Service.