What Is Triple Extortion? The Anatomy of the Encryption + Leakage + DDoS Trio

**Executive summary:** This report describes the rise and mechanics of triple extortion ransomware—combining encryption, large-scale data exfiltration and public leak threats, and concurrent DDoS—to maximize payment pressure; it outlines the multi-phase attack lifecycle, provides a major healthcare case study (~193M records exposed, $22M ransom), and prescribes detection and defense controls (dark web monitoring, IAB surveillance, immutable backups, EDR, DLP, and DDoS mitigation) to detect and disrupt attacks prior to the ransom note.