The Medal of Honor was created during the American Civil War. It is the highest military decoration presented by the United States government to a member of its armed forces. The recipient must have distinguished themselves at the risk of their own life above and beyond the call of duty in action against an enemy of the United States. Due to the nature of this medal it is commonly presented after the recipient has been killed (posthumously).
Although Medals of Honor can be presented only to members of the U.S. armed forces it is not required to be a U.S. citizen. Since the American Civil War hundreds of people born outside the United States have received the medal. The most recent of these recipients being Leslie H. Sabo, Jr.. He received his medal in May 2012 for actions performed during the Vietnam War. The large number of foreign-born recipients during the 19th and early 20th centuries was likely due to immigration waves from Europe.