The Keila town medal of honour was inaugurated on 12 May 1998 by an order of the town council to commemorate the 60th anniversary of Keila being declared a town. The council awards the medal to those, Estonian or foreigner, who have been of great service to the town.
The medal is made of white metal and features a design of stylised pine trees with the Keila coat of arms between them. The background of the coat of arms is of gold plate, and the cornflower is made of blue enamel. The number and year of award of each medal are engraved on the back. The medal is a smaller version of the central motif of the mayor's chain of office. In 2002 the town council decided that recipients of the medal would also get a miniature of it, an exact copy of the medal measuring 15mm by 20 mm, which could be worn everyday with the medal itself reserved for festive occasions.
The Keila medal of honour and accompanying certificate were deigned by the artists Kuldar Hütt and Terje-Irena Hütt.