Maid of honor badges consisted of the reigning Empress's initials surmounted by the Imperial crown. When a new empress ascended to the throne, or upon the death of a dowager empress, the design was changed. The present badge is in the form of the Cyrillic initials 'MA', which stand for Dowager Empress Maria Feodorovna and Empress Alexandra Feodorovna, dating the badge to the reign of Nicholas II. The placement of the initial of the Dowager Empress on the left signified her higher rank within the court hierarchy.
Badges were worn on the lady's left shoulder, suspended from the ribbon of the Order of St. Andrew, whenever court dress was prescribed. While the cost of each badge was between 500 and 900 rubles, they were provided free of charge to the recipients.