The Iraq Medal was awarded to those meeting the qualifying period of service within the defined operational area. Eligibility was extensive, and included both Regular and Reserve members of the armed forces, foreign and Commonwealth exchange and attached forces, Ministry of Defence civilians, members of the Royal Fleet Auxiliary and embedded journalists.

The operational area was defined as being divided into two zones - Zone 1 (Iraq and Kuwait) and Zone 2 (elsewhere within the Gulf region). Qualifying periods of service varied depending on the area in which personnel were based.

The medal was awarded with the clasp "19 Mar to 28 Apr 2003" to British service and attached personnel who:

served in Zone 1 (Iraq) between 19 March and 28 April 2003, the period that encompassed the duration of initial combat operations, and who:
completed seven days continuous service; or served as aircrew flying into Iraq and who completed two or more operational sorties (no more than one sortie per day could count).