Received from achieving Prestige 1 level 50 in PvP. Starts the quest  A Royal Audience, in which Anduin awards the player this medal as well as an artifact appearance in front of an audience of several faction leaders and battleground leaders.
While the item is what starts the quest, it appears to be officially rewarded after speaking with Anduin. It is removed from the player's bags, meaning that its awarding does not give any form of visible physical medal, but can be assumed in the character's possession.
This page was last edited on 13 September 2018, at 00:19.
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