A relatively new ransomware group and strain known as BlackSuit, with significant similarities to the Royal ransomware family, will likely be a credible threat to the Healthcare and Public Health (HPH) sector.

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HC3: Analyst Note November 6, 2023 TLP:CLEAR Report: 202311061700
BlackSuit Ransomware
Executive Summary
A relatively new ransomware group and strain known as BlackSuit, with significant similarities to the Royal
ransomware family, will likely be a credible threat to the Healthcare and Public Health (HPH) sector.
Discovered in early May 2023, BlackSuit’s striking parallels with Royal, the direct successor of the former
notorious Russian-linked Conti operation, potentially places the group with one of the most active
ransomware groups in operation today. Both Royal and the now defunct Conti are known to have
aggressively targeted the HPH sector, and if their purported ties to BlackSuit prove to be verified, then the
sector will likely continue to be attacked profoundly. What follows is an overview of the potential new
group, possible connections to other threat actors, an analysis of its ransomware attacks, its target
industries and victim countries, impact to the HPH sector, MITRE ATT&CK techniques, indicators of
compromise, and recommended defense and mitigations against the group.
Overview
BlackSuit operates using a double extortion method that steals and encrypts sensitive data on a
compromised network. So far, the specific use of BlackSuit ransomware has been observed in a small
number of attacks. The most recent suspected attack, in October 2023, was against a U.S.-based HPH
organization whose servers and systems were encrypted with malware, tentatively identified as BlackSuit.
One cybersecurity company also documented at least three attacks involving the BlackSuit encryptor, with
ransoms below $1 million. Another company annotated at least five attacks in the manufacturing,
business technology, business retail, and government sectors spanning the United States, Canada, Brazil,
and the United Kingdom. With only a small number of victims, the ransomware gang is considered more
infamous for their purported connections to the more profilic Royal ransomware family. If their connection
is confirmed, it would augment BlackSuit as a threat actor to be closely watched in the near future.
BlackSuit Ransomware at a Glance
Names Utilized BlackSuit, Black Suit, BlackSuit Virus
Threat Type Ransomware; Crypto Virus; Files Locker; Double Extortion
Encrypted Files Extension .BlackSuit
Ransom Demanding Message README.Blaclsuit.txt
Detection Names
Avast Win32:Malware-gen
Kaspersky HEUR:Trojan-Ransom.Win32.Generic
Sophos Mal/Generic-S (PUA)
Microsoft Ransom:Win32/BlackSuit.B
Distribution Methods Infected email attachments (macros), torrent websites, malicious ads,
Trojans
Consequences Files are encrypted and locked until the ransom is paid; data is leaked;
double extortion
Associations
BlackSuit operates as a private ransomware operation without any known affiliates, and is therefore not
considered to be a Ransomware-as-a-Group (RaaS). Its operators are likely experienced, due to the
potential ties to Royal (and by default, Conti). Both Royal and the former Conti groups were known to have
well-known organizational systems, business models, and skilled operators.
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HC3: Analyst Note November 6, 2023 TLP:CLEAR Report: 202311061700
Following a May 2023 attack on a major city in Texas by the Royal ransomware group, many cybersecurity
researchers speculated that they would rebrand under a new name after widespread media attention and
pressure from law enforcement. A new BlackSuit ransomware operation was discovered in the same
month that was using its own branded encryptor and Tor negotiation sites. It was believed that this was the
ransomware operation that the Royal ransomware group would rebrand into. However, a rebrand never
occurred, and Royal is still actively attacking the enterprise while using BlackSuit in limited attacks.
One cybersecurity company’s analysis of the Linux variant of BlackSuit uncovered significant similarities to
the Royal ransomware family. The reseachers, who examined an x64 VMware ESXi version targeting Linux
machines, said that they identified an “extremely high degree of similarity” between Royal and BlackSuit.
Furthermore, they stated that “they’re nearly identical, with 98% similarities in functions, 99.5%
similarities in blocks, and 98.9% similarities in jumps based on BinDiff, a comparison tool for binary files.”
A comparison of the Windows artifacts has identified 93.2% similarity in functions, 99.3% in basic blocks,
and 98.4% in jumps based on BinDiff.
The most recent findings from the same company note that BlackSuit and Royal use OpenSSL’s AES for
encryption, and utilize similar intermittent encryption techniques to speed up the encryption process.
Overlaps aside, BlackSuit incorporates additional command-line arguments and avoids a different list of
files with specific extensions during enumeration and encryption. The emergence of BlackSuit ransomware
(with its similarities to Royal) indicates that it is either a new variant developed by the same authors, a
copycat using similar code, an affiliate of the Royal ransomware gang that has implemented modifications
to the original family, or emerged from a splinter group within the original Royal ransomware family.

Conti Ransomware
First observed in 2019, Conti is a Russian-speaking RaaS group connected to more than 400 multi-sector
cyberattacks, three-quarters of which were based in the United States. Notorious for their aggressive
tactics and large-scale attacks, they were known for demanding ransoms as high as $25 million. Often
conducting double extortion, they relied on affiliates to target organizations with more than $100 million in
annual revenue. However, leaked chats showed that some Conti members began to question the targeting
of the healthare sector, especially during the height of the COVID-19 pandemic. This led to speculation that
there might be a fracturing within the group. Subsequently, following a multi-government sting operation in
February 2022, the group disbanded, splintered into smaller groups, and rebranded to evade law
enforcement. Despite the shutdown of that particular threat group, Conti operators remain active and
collaborative in new factions, like Royal. For additional information on the Conti threat group, see four
previous HC3 reports: Overview of Conti Ransomware, Conti Ransomware Amplify Alert, Conti Ransomware
(Update), and Conti Ransomware and the Health Sector.
Royal Ransomware
First observed in 2022, the Royal ransomware gang thrived after the post-Conti disbanding. In its early
campaigns, Royal deployed BlackCat’s encryptor. It then shifted to its own called Zeon, which dropped
ransom notes similar to Conti’s. Royal later rebranded and began using Royal in the ransom notes
generated by its new encryptor. The group combines the use of old and new techniques, suggesting an
extensive knowledge of the ransomware scene. Their use of callback phishing to deceive victims into
installing remote desktop malware lets them infiltrate victims’ machines with minimal effort. Meanwhile,
the ransomware group’s intermittent encryption tactics also speed up their encryption of victims’ files. In
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previous attacks, the group has requested ransom payments from $250,000 to over $2 million.
Unlike their predecessor, Royal appears to not operate as a RaaS, but as a private group without any
affiliates. With financial motivation as their primary goal, the group steals data from double extortion
attacks. Royal compromises have affected multiple industries, including the HPH sector. For additional
information on the Royal threat group, see two previous HC3 reports: Royal Ransomware and Royal &
BlackCat Ransomware: The Threat to the Health Sector.
Technical Details
BlackSuit primarily targets Linux and Windows systems, and prevents victims from accessing their files by
encrypting them. BlackSuit appends the blacksuit file extension (“.blacksuit”) to the files it encrypts,
changes the desktop wallpaper, creates and drops its ransom note (“README.BlackSuit.txt”) into the
directory, renames files, and lists its TOR chat site in the ransom note along with a unique ID for each of its
victims. Its operators also set up a data leak site as part of their double extortion strategy to coerce victims
into paying the ransom demand. The BlackSuit ransom note will make several claims, most notably that
essential files have been encrypted and stored on a secure server; therefore, any financial reports,
intellectual property, personal files, and other sensitive data have been compromised. Currently, there is
no known public decryptor for BlackSuit ransomware available.
Once the ransomware infects a system, it uses the FindFirstFileW() and FindNextFileW() API functions to
enumerate the files and directories, and initiates the encryption process. BlackSuit ransomware uses the
Advanced Encryption Standard (AES) algorithm to encrypt files. The AES algorithm is a symmetric
encryption algorithm that is widely used for encrypting data. BlackSuit ransomware uses OpenSSL’s AES
for encryption, and leverages similar intermittent encryption techniques for fast and efficient encryption of
victim files.
Figure 1: BlackSuit Ransom Note (Source: TrendMicro)
Variants
Windows Variant: The 32-bit Windows variants of the BlackSuit and Royal ransomware families share a
93.2% similarity in functions, 99.3% similarity in basic blocks, and 98.4% similarity in jumps based on
BinDiff. BlackSuit and Royal use OpenSSL’s AES for encryption and leverage similar intermittent encryption
techniques.
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Linux Variant: The Linux variant of the BlackSuit ransomware is a 64-bit ELF executable compiled with GCC
with sha256 as 1c849adcccad4643303297fb66bfe81c5536be39a87601d67664af1d14e02b9e. The
Linux variants of Royal and BlackSuit share 98% similarity in function, 99.5% similarity in blocks, and
98.9% similarity in jumps based on the BinDiff comparison tool.

Distribution Methods
Infected email attachments (macros): Cybercriminals may distribute BlackSuit ransomware through email
attachments that contain infected links or macros. Users who open these attachments or enable macros
can inadvertently trigger the execution of the ransomware on their system.
Torrent websites: BlackSuit ransomware can be embedded into torrent files, which are commonly used for
downloading and sharing files through peer-to-peer networks. When users download and open these
infected torrent files, their systems can become infected with the ransomware.
Malicious ads: Malicious ads, also known as malvertising, can be used as a method to distribute BlackSuit
ransomware. Users who click on these ads may be redirected to websites that automatically download and
install the ransomware on their system.
Trojans: BlackSuit ransomware can be delivered through Trojans, which are malicious programs that can
download and install other types of malware, including ransomware. Trojans can be distributed through
various means, such as phishing emails, fake software updates, or compromised websites.
Target Countries and Industries
With only a small number of victims, it is difficult to draw any tangible conclusions about the BlackSuit
threat group’s preferred targets, if any. Thus far, the group has targeted the following countries: The United
States, Canada, Brazil, and the United Kingdom. If ties to Royal (and by extension, Conti) are confirmed,
then the correlation to these Russian-speaking threat actors will likely support a geographic exclusionary
pattern by the group. Both Royal and Conti are known to exclude ex-Soviet or Commonwealth of
Independent States (CIS) countries from being targeted in attacks. Additionally, while only a few victims are
known, its target industries appear to be indiscriminate, including the healthcare, manufacturing, business
technology, business retail, and government sectors. Continued monitoring of this group over the next year
will likely demonstrate more about their motivations and specific targeting preferences.
Impact to Healthcare and Public Health (HPH) Sector
BlackSuit has only one purported victim from the HPH sector in the United States. The ransomware attack
was significant, as the victim provides medical scans and radiology services for almost 1,000 hospitals
and health systems in 48 states. The initial impact of the attack caused the victim to shut down computer
systems and turn away patients at fixed-site locations. No further details are known at this time, although
given the ubiquitous geographic presence of the victim, significant impacts could still follow. Given both
Royal and Conti’s longstanding record of targeting this particular sector, if BlackSuit’s ties to either of the
two groups is confirmed, then the healthcare industry should anticipate more attacks to come.
MITRE ATT&CK Techniques
Several cybersecurity researchers have annotated specific MITRE ATT&CK techniques.


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HC3: Analyst Note November 6, 2023 TLP:CLEAR Report: 202311061700
MITRE ATT&CK TTPs of BlackSuit Ransomware (Source: Cyble)
Tactic Technique ID Technique Name
Execution T1204 User Execution
T1059 Command and Scripting Interpreter
Discovery
T1057 Process Discovery
T1082 System Information Discovery
T1083 File and Directory Discovery
Impact T1486 Data Encrypted for Impact
T1490 Inhibit System Recovery
Indicators of Compromise (IOCs)
BlackSuit IOCs (Source: Alien Vault)
FileHash-MD5 2902e12f00a185471b619233ee8631f3
FileHash-MD5 4f813698141cb7144786cdc6f629a92b
FileHash-MD5 748de52961d2f182d47e88d736f6c835
FileHash-MD5 9656cd12e3a85b869ad90a0528ca026e
FileHash-SHA1 30cc7724be4a09d5bcd9254197af05e9fab76455
FileHash-SHA1 69feda9188dbebc2d2efec5926eb2af23ab78c5d
FileHash-SHA1 7e7f666a6839abe1b2cc76176516f54e46a2d453
FileHash-SHA1 861793c4e0d4a92844994b640cc6bc3e20944a73
FileHash-SHA256 1c849adcccad4643303297fb66bfe81c5536be39a87601d67664af1d14e02b9e
FileHash-SHA256 4d7f6c6a051ecb1f8410243cd6941b339570165ebcfd3cc7db48d2a924874e99
BlackSuit IOCs (Source: Cyble)
Indicator Indicator Type Description
748de52961d2f182d47e88d736f6c835 MD5 BlackSuit Windows
Executable
30cc7724be4a09d5bcd9254197af05e9fab76455 SHA1 BlackSuit Windows
Executable
90ae0c693f6ffd6dc5bb2d5a5ef078629c3d77f874b2d2ebd9e109d8ca049f2c SHA256 BlackSuit Windows
Executable
9656cd12e3a85b869ad90a0528ca026e MD5 BlackSuit Linux
Executable
861793c4e0d4a92844994b640cc6bc3e20944a73 SHA1 BlackSuit Linux
Executable
1c849adcccad4643303297fb66bfe81c5536be39a87601d67664af1d14e02b9e SHA256 BlackSuit Linux
Executable
BlackSuit IOCs (Source: Trend Micro)
SHA256 Detection Name
90ae0c693f6ffd6dc5bb2d5a5ef078629c3d77f874b2d2ebd9e109d8ca049f2c Ransom.Win32.BLACKSUIT.THEODBC
1c849adcccad4643303297fb66bfe81c5536be39a87601d67664af1d14e02b9e Ransom.Linux.BLACKSUIT.THEODBC
6ac8e7384767d1cb6792e62e09efc31a07398ca2043652ab11c090e6a585b310 Ransom.Win32.ROYAL.AA
4d7f6c6a051ecb1f8410243cd6941b339570165ebcfd3cc7db48d2a924874e99 Ransom.Win32.ROYAL.SMYECJYT
b57e5f0c857e807a03770feb4d3aa254d2c4c8c8d9e08687796be30e2093286c Ransom.Linux.ROYAL.THBOBBC
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Defense and Mitigations
Organizations can defend against ransomware attacks by implementing a comprehensive security
framework that directs resources towards establishing a strong defense strategy. Here are some
recommendations:
• Create an inventory of assets and data
• Identify authorized and unauthorized devices and software
• Conduct audits of event and incident logs
• Manage hardware and software configurations
• Grant administrative privileges and access only when necessary
• Monitor network ports, protocols, and services
• Establish a whitelist of approved software applications
• Implement measures for data protection, backup, and recovery
• Enable multi-factor authentication (MFA)
• Deploy up-to-date security solutions across all system layers
• Remain vigilant for early indications of an attack
For U.S. residents and businesses, the local Federal Bureau of Investigation (FBI) field office and the
Internet Crime Complaint Center (IC3) can assist with reporting a cybercrime incident. When reporting a
ransomware attack, any information about it must be gathered, including:
• Screenshots of the ransom note
• Communications with the ransomware actors (if you have them)
• A sample of an encrypted file
The Way Forward
The disintegration of the Conti team produced new threat actors, many of whom carried on the legacy of
the former Russian-speaking group. One of its progeny, Royal, has proven itself to be an aggressive and
formidable ransomware actor in its indiscriminate targeting, but especially against the HPH sector.
BlackSuit, while still in its infancy, has also shown the destructive potential of its attacks. The group’s
coding and encryption correlations to Royal demonstrate the difficulty in ascertaining whether it is a novel
ransomware operation, or a continuation of a previous threat actor. BlackSuit’s ties to the former two
groups notwithstanding, its ransomware is currently being actively employed in cyberattacks across
multple industries and countries. The value of HPH data, in particular, signals that the healthcare industry
will remain a viable target to this threat actor. In addition to the aforementioned defense and mitigation
strategies, HC3 recommends that HPH organizations utilize resources from CISA Stop Ransomware, HHS
405(d), and the H-ISAC to proactively and reactively aid healthcare organizations with cybersecurity
awareness and guidance.
The probability of cyber threat actors targeting any industry remains high, but especially so for the
Healthcare and Public Health sector. Prioritizing security by maintaining awareness of the threat
landscape, assessing the situation, and providing staff with tools and resources necessary to prevent a
cyberattack remain the best ways forward for healthcare organizations.

Relevant HHS Reports
HC3: Alert – Conti Ransomware Amplify Alert (September 30, 2021)

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Health Sector Cybersecurity Coordination Center (HC3) www.HHS.GOV/HC3
HC3: Analyst Note November 6, 2023 TLP:CLEAR Report: 202311061700
HC3: Alert – Conti Ransomware (Update) (March 10, 2022)
HC3: Alert - Russian State-Sponsored and Criminal Cryber Threats to Critical Infrastructure (May 9, 2022)

HC3: Alert - Understanding and Mitigating Russian State-Sponsored Cyber Threats to U.S. Critical
Infrastructure (March 1, 2022)
HC3: Analyst Note – Healthcare Sector DDoS Guide (February 13, 2023)

HC3: Analyst Note – Overview of Conti Ransomware) May 25, 2021

HC3: Analyst Note – Royal Ransomware (December 7, 2022)

HC3: Threat Briefing – Conti Ransomware and the Health Sector (July 8, 2021)

HC3: Threat Briefing – Royal & BlackCat Ransomware: The Threat to the Health Sector (January 12, 2023)
References
Abrams, Lawrence. “Royal ransomware gang adds BlackSuit encryptor to their arsenal.” Bleeping
Computer. June 8, 2023. https://www.bleepingcomputer.com/news/security/royal-ransomware-gangadds-blacksuit-encryptor-to-their-arsenal/
“BlackSuit Ransomware.” Alien Vault. Accessed October 30, 2023.
https://otx.alienvault.com/pulse/647f01fd5dd3c8a8ff27730f
“BlackSuit Ransomware Strikes Windows and Linux Users.” Cyble. May 12, 2023.
https://cyble.com/blog/blacksuit-ransomware-strikes-windows-and-linux-users/
“BlackSuit Ransomware Targeting Linux and Windows.” Alvaka. Accessed October 30, 2023.
https://www.alvaka.net/blacksuit-ransomware-targeting-linux-and-windows/
Casona, Katherine and Ivan Nichole Chavez, Ieriz Gonzalez, Jeffrey Francis Bonaobra. “Investigating
BlackSuit Ransomware’s Similarities to Royal.” Trend Micro. May 31, 2023.
https://www.trendmicro.com/en_us/research/23/e/investigating-blacksuit-ransomwares-similarities-toroyal.html
“FSC leak: Hacked files dumped on dark web.” Jamaica Observer. September 17, 2023.
https://www.jamaicaobserver.com/business/fsc-leak/
Greig, Jonathan. “Tampa Bay zoo targeted in cyberattack by apparent offshoot of Royal ransomware.” The
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“In the throes of bankruptcy and hit by a ransomware attack, Akumin still unable to provide many
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Health Sector Cybersecurity Coordination Center (HC3) www.HHS.GOV/HC3
HC3: Analyst Note November 6, 2023 TLP:CLEAR Report: 202311061700
Lakshmanan, Ravie. “New Linux Ransomware Strain BlackSuit Shows Striking Similarities to Royal.” The
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Moody, Rebecca. “Map of worldwide ransomware attacks (updated daily).” Comparitech. Updated October
30, 2023. https://www.comparitech.com/blog/information-security/global-ransomware-attacks/
Pandagle, Vishwa. “BlackSuit Ransomware Target’s Brazil’s Government Portal.” The Cyber Express.
October 20, 2023. https://thecyberexpress.com/government-of-brazil-cyberattack-by-blacksuit/
Sabin, Sam. “Inside Royal’s ransomware spree against U.S. cities.” Axios. May 9, 2023.
https://www.axios.com/2023/05/09/royal-ransomware-us-cities-cybersecurity-hacking
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