On April 11th, 1966,  while defending some of his wounded comrades. For his bravery and sacrifice, he was posthumously awarded the nation's second highest military decoration, the Air Force Cross. "Pits", as he was known to his friends, was nearing his 300th combat mission on that fateful day when some men of the U.S. Army's 1^st Division were ambushed and pinned down in an area about 45 miles east of Saigon. Two HH-43 "Huskie" helicopters of the USAF's 38^th Aerospace Rescue and Recovery Squadron were rushed to the scene to lift out the wounded. Pits was a pararescuemen (PJ) on one of them. Upon reaching the site of the ambush, Pits was lowered through the trees to the ground where he attended to the wounded before having them lifted to the helicopter by cable. After six wounded men had been flown to an aid station, the two USAF helicopters returned for their second loads.

As When its engine began to lose power, the pilot realized he had to get the Huskie away from the area as soon as possible. Instead of climbing into the litter basket so he could leave with the helicopter, Pits elected to remain with the Army troops under enemy attack and he gave a "wave-off" to the helicopter which flew away to safety. one of them lowered its litter basket to Pitsenbarger, who had remained on the ground with the 20 infantrymen still alive, it was hit by a burst of enemy small-arms fire.

Pits continued to treat the wounded and, when the others began running low on ammunition, he gathered ammo clips from the dead and distributed them to those still alive. Then, he joined the others with a rifle to hold off the Viet Cong. About 7:30 PM that evening, Bill Pitsenbarger was killed by Viet Cong snipers. When his body was recovered the next day, one hand still held a rifle and the other a medical kit. A1C William H. Pitsenbarger, a PJ who participated in more than 300 rescue missions, is shown putting on a parachute, scuba tanks and other equipment for a jump into water. In Vietnam, PJs --all volunteers-- earned more decorations per capita than any other group of USAF personnel.