The most important feature of the Athens 2004 Olympic medals is the Greek language and alphabet, shown on both sides. All Olympic medals subsequently symbolise the Greek origin of the Olympic Games, as well as their modern revival in 1896.

With respects to the design of the medal, the position of goddess Nike was changed. Until the 2000 Sydney Games, she was represented as seated, holding a corn ear in one hand and a wreath in the other. From the 2004 Athens Olympiad on, Nike enters the stadium bringing victory and joy to the best world athletes.

The organising Committee has chosen to show on the medals the Panathenean Stadium, where the modern Olympic Games resumed in 1896. On the obverse, the athlete’s disciplinary code will also be engraved.

The reverse side of the medal displays three main elements:
- the eternal flame lit at the Olympia, which will cross the five continents;
- the opening lyrics of Pindar's Eighth Olympic Ode, composed in 460 BC to honour the victory of Alkimedon of Aegina in wrestling;
the Athens 2004 Olympic Games emblem, with the symbolic olive branch.

The total number of medals were 1,130 gold, 1,130 silver, and 1,150 bronze.