The shield of the Medicine Hat coat of arms is gold and black, representing the "black gold" of the petroleum industry, as well as the golden wheat of the agriculture of the area. The train wheel and the cog wheel represent transportation and industry (cliche, cliche); the gas-light represents Medicine Hat's claim to fame as one of the first cities in the area to have gas-lights, due to the cheap supply of natural gas (represented in the base of the shield as natural gas flames). The wavy fess, of course, represents the South Saskatchewan river, which flows through the city (an even worse cliche than the wheels).

The crest consists of a mural crown charged with ears of wheat, and the hat of a medicine man (after which, of course, the town is named). The supporters are a horse (representative of ranching) and a tyger (a heraldic creature, not to be confused with a tiger, which is normally orange and striped), the latter issuing flames of natural gas. Both supporters are collared, the horse with maple leaves (Canada) and the tyger with wild roses (Alberta).

The motto translates as "With spirit and faith".

Image taken from here, with permission.