Rought enlisted in the Army as a corporal on 18 August 1862 at Crampton, Pennsylvania. He was mustered into Company A of the 141st Pennsylvania Infantry. He was promoted to sergeant on 18 November 1862. He was wounded and captured by the Confederates on 3 May 1863 at the Battle of Chancellorsville, but was released soon after. On 6 May 1864, before a charge on the 13th North Carolina Infantry, a veteran unit, Rought found that he had lost his bayonet the night before. During the charge, he killed the Confederate color sergeant with the stock of his musket and captured the unit's flag. For this action, he was awarded the Medal of Honor. He was later seriously wounded on 12 May 1864 at the Battle of Spotsylvania Court House in Virginia and was in a Washington D.C. hospital at the time of his muster out of service on 28 May 1865.[4][5]
Rought's Medal of Honor citation reads:[3]
The President of the United States of America, in the name of Congress, takes pleasure in presenting the Medal of Honor to Sergeant Stephen Rought, United States Army, for extraordinary heroism on 6 May 1864, while serving with Company A, 141st Pennsylvania Infantry, in action during the Wilderness Campaign, Virginia, for capture of flag of 13th North Carolina Infantry (Confederate States of America).
— E. M. Stanton, Secretary of War