The central focus of the medal is the bold inscription "TEXAS TOUGH", prominently displayed. The design incorporates a stylized cowboy figure, complete with a hat and gear, symbolizing strength and resilience. The background includes a sunburst design and elements that evoke a sense of the Texan landscape. The design also includes the distance options (5K and 10K), the year 2023, and the event's location in Helotes, Texas. The ribbon attached to the medal is black and decorated with a gold abstract pattern, offering a complementary contrast to the medal's design. This medal is a remarkable piece, designed to be cherished for years to come.