Pilila?au's official Medal of Honor citation reads:

Pfc. Pililaau, a member of Company C, distinguished himself by conspicuous gallantry and outstanding courage above and beyond the call of duty in action against the enemy. The enemy sent wave after wave of fanatical troops against his platoon which held a key terrain feature on "Heartbreak Ridge." Valiantly defending its position, the unit repulsed each attack until ammunition became practically exhausted and it was ordered to withdraw to a new position. Voluntarily remaining behind to cover the withdrawal, Pfc. Pililaau fired his automatic weapon into the ranks of the assailants, threw all his grenades and, with ammunition exhausted, closed with the foe in hand-to-hand combat, courageously fighting with his trench knife and bare fists until finally overcome and mortally wounded. When the position was subsequently retaken, more than 40 enemy dead were counted in the area he had so valiantly defended. His heroic devotion to duty, indomitable fighting spirit, and gallant self-sacrifice reflect the highest credit upon himself, the infantry, and the U.S. Army.

Pililaau, Herbert Kaili, PFC