Conventions to add a new protection symbol requires a diplomatic conference of all 192 signatory states to the Conventions. The Swiss government organized such a conference to take place on December 5–6, 2005, to adopt a third additional protocol to the Geneva Conventions introducing the Red Crystal as an additional symbol with equal status to the Red Cross or Red Crescent. Following an unplanned extension of the conference until December 7, the protocol was adopted after a vote successfully achieved the required two-thirds majority. From the countries which attended the conference, 98 voted in favour and 27 against the protocol, while 10 countries abstained from voting.

In the third Protocol the new symbol is referred to as "the third Protocol emblem". The rules for the use of this symbol, based on the third additional protocol to the Geneva Conventions, are the following:

* Within its own national territory, a national society can use either of the recognized symbols alone, or incorporate any of these symbols or a combination of them into the Red Crystal. Furthermore, a national society can choose to display a previously and effectively used symbol, after officially communicating this symbol to the state parties of the Geneva Conventions through Switzerland as the depositary state prior to the adoption of the proposed third additional protocol.

* For indicative use on foreign territory, a national society which does not use one of the recognized symbols as its emblem has to incorporate its unique symbol into the Red Crystal, based on the previously mentioned condition about communicating its unique symbol to the state parties of the Geneva Conventions.

* For protective use, only the symbols recognized by the Geneva Conventions can be used. Specifically, those national societies which do not use one of the recognized symbols as their emblem have to use the Red Crystal without incorporation of any additional symbol.

On 22 June 2006 the ICRC announced that the International Red Cross and Red Crescent Movement adopted the Red Crystal as additional emblem for use by the national societies. The ICRC also announced the recognition of the Palestine Red Crescent Society (PRCS) and the Israeli National Society, Magen David Adom (MDA). On 14 January 2007, the third additional protocol entered into force.