H-ISAC TLP White Threat Update: UPDATE: Joint Cybersecurity Advisory - Conti Ransomware

Health-ISAC is issuing a threat bulletin regarding ongoing and increased Conti Ransomware activity provided in an updated Joint Cybersecurity Advisory (AA21-265A) by the United States Cybersecurity and Infrastructure Security Agency (CISA), the Federal Bureau of Investigation (FBI), the National Security Agency (NSA), and the United States Secret Service (USSS). Conti Ransomware affiliates remain active in which reported cyber attacks stemming from their ransomware-as-a-service (RaaS) operations against US and international organizations are increasing.  

Updated March 9, 2022:  

This Joint Cybersecurity Advisory was updated to include new indicators of compromise and the United States Secret Service as a co-author.

Updated February 28, 2022: 

Conti cyber threat actors remain active and reported Conti ransomware attacks against US and international organizations have risen to more than 1,000. Notable attack vectors include Trickbot and Cobalt Strike.  

While there are no specific or credible cyber threats to the US homeland currently, CISA, FBI, and the NSA encourage organizations to review this advisory and apply the recommended mitigations.  

The Cybersecurity and Infrastructure Security Agency (CISA) and the Federal Bureau of Investigation (FBI) have observed the increased use of Conti ransomware in more than 400 attacks on US and international organizations. (See FBI Flash: Conti Ransomware Attacks Impact Healthcare and First Responder Networks.) In typical Conti ransomware attacks, malicious cyber actors steal files, encrypt servers and workstations, and demand a ransom payment.  

To secure systems against Conti ransomware, CISA, FBI, and the National Security Agency (NSA) recommend implementing the mitigation measures described in this advisory, which include requiring multifactor authentication (MFA), implementing network segmentation, and keeping operating systems and software up to date. 

All members are encouraged to review AA21-265A: Conti Ransomware which has been attached to this alert. 


While Conti is considered a ransomware-as-a-service (RaaS) model ransomware variant, there is variation in its structure that differentiates it from a typical affiliate model. It is likely that Conti developers pay the deployers of the ransomware a wage rather than a percentage of the proceeds used by affiliate cyber actors and receives a share of the proceeds from a successful attack.  

Conti actors often gain initial access [TA0001] to networks through: 

  • Spearphishing campaigns using tailored emails that contain malicious attachments [T1566.001] or malicious links [T1566.002]; 
  • Malicious Word attachments often contain embedded scripts that can be used to download or drop other malware—such as TrickBot and IcedID, and/or Cobalt Strike—to assist with lateral movement and later stages of the attack life cycle with the eventual goal of deploying Conti ransomware.  
  • Stolen or weak Remote Desktop Protocol (RDP) credentials [T1078].[4
  • Phone calls. 
  • Fake software promoted via search engine optimization.
  • Other malware distribution networks (e.g., ZLoader) 
  • Common vulnerabilities in external assets. 

In the execution phase [TA0002], actors run a getuid payload before using a more aggressive payload to reduce the risk of triggering antivirus engines. CISA and FBI have observed Conti actors using Router Scan, a penetration testing tool, to maliciously scan for and brute force [T1110] routers, cameras, and network-attached storage devices with web interfaces. Additionally, actors use Kerberos attacks [T1558.003] to attempt to get the Admin hash to conduct brute force attacks. 

Conti actors are known to exploit legitimate remote monitoring and management software and remote desktop software as backdoors to maintain persistence [TA0003] on victim networks. The actors use tools already available on the victim network—and, as needed, add additional tools, such as Windows Sysinternals and Mimikatz—to obtain users’ hashes and clear-text credentials, which enable the actors to escalate privileges [TA0004] within a domain and perform other post-exploitation and lateral movement tasks [TA0008]. In some cases, the actors also use TrickBot malware to carry out post-exploitation tasks. 

According to a recently leaked threat actor “playbook,” Conti actors also exploit vulnerabilities in unpatched assets, such as the following, to escalate privileges [TA0004] and move laterally [TA0008] across a victim’s network: 

  • 2017 Microsoft Windows Server Message Block 1.0 server vulnerabilities 
  • "PrintNightmare" vulnerability (CVE-2021-34527) in Windows Print spooler service 
  • "Zerologon" vulnerability (CVE-2020-1472) in Microsoft Active Directory Domain Controller systems. 

Artifacts leaked with the playbook identify four Cobalt Strike server Internet Protocol (IP) addresses Conti actors previously used to communicate with their command and control (C2) server. 

  • 162.244.80[.]235 
  • 85.93.88[.]165 
  • 185.141.63[.]120 
  • 82.118.21[.]1 

CISA and FBI have observed Conti actors using different Cobalt Strike server IP addresses unique to different victims. 

Conti actors often use the open-source Rclone command-line program for data exfiltration [TA0010]. After the actors steal and encrypt the victim's sensitive data [T1486], they employ a double extortion technique in which they demand the 

victim pay a ransom for the release of the encrypted data and threaten the victim with public release of the data if the ransom is not paid. 

Additional Details: 

For additional details including the list of updated indicators of compromise and MITRE ATT&CK Techniques, please see the full report here 

Organizations are encouraged to ingest the updated IOCs manually if no automatic ingestion systems are implemented. For Health-ISAC members who have implemented the Health-ISAC Indicator Threat Sharing (HITS) program, the IOCs related to this alert have been automatically imported into your environment. 

View the detailed reports below. 

For help with Cybersecurity and Risk Advisory Services exclusively for AHA members, contact:

John Riggi

National Advisor for Cybersecurity and Risk, AHA


(O) +1 202 626 2272