Former Staff Sgt Clinton Romesha, 31, led a battle against hundreds of Taliban fighters four years ago.
About 50 US soldiers were at Combat Outpost Keating near Pakistan when it was almost overrun by insurgents.
He is the fourth living veteran of Afghanistan or Iraq to receive America's highest military award.
The father-of-three lives with his family in Minot, North Dakota, and works in oil-field safety.
According to the Army's official narrative, at about 06:00 on 3 October 2009, some 400 Taliban fighters targeted Combat Outpost Keating in Kamdesh District, Nuristan Province, while many key US officers were off base.
The outpost was surrounded on four sides by insurgents who had occupied the high ground and began to attack with rocket-propelled grenades (RPGs), mortars, heavy machine-gun fire and small-arms fire.
Sgt Romesha is said to have frequently exposed himself to withering enemy fire as he led the fightback.
He killed a team of machine-gun fighters, and was peppered with shrapnel when an RPG landed close to his position.
Ignoring his wounds, Sgt Romesha then killed more enemy fighters, including a nest of machine-gunners and a sniper.
He then killed three Taliban fighters as they were breaching the outpost's perimeter.
Sgt Romesha also led a team to secure an ammunition supply point and then turned his attention to defending a vulnerable entry point.
From there, he was able to pinpoint the origin of enemy fire at a nearby village, Urmul, and at an Afghan National Police checkpoint that had been seized by the insurgents.
According to the official narrative, he helped to direct air support and 120mm mortars to target the enemy positions.
Finally, Sgt Romesha helped wounded troops to withdraw to a safe location and recovered the bodies of two soldiers who died in the attack.
Eight US soldiers were killed and another 22 were wounded, including Sgt Romesha.
The official citation says that Sgt Romesha personally killed 10 Taliban fighters and was instrumental in the deaths of another 35.
Last month, after learning he would get the award, he told a news conference: "You're not going to back down in the face of adversity like that. We were just going to win, plain and simple."
US President Barack Obama has presented the Medal of Honor to a former soldier for his heroism during a huge firefight in Afghanistan.