A healthcare company uses AWS Amplify to host a patient management system.

DynamoDB already supports encryption at rest by default (with AWS owned keys or AWS managed/customer managed KMS keys). However, the requirement here is stronger and explicit: patient data must be encrypted before it is stored in DynamoDB, meaning the encryption must occur client-side / application-side so that the data remains encrypted as it traverses the stack and is still encrypted when written to the table. This is often required for highly sensitive PII/PHI where administrators or downstream systems should not see plaintext.

Option A meets this requirement by encrypting the payload inside the Lambda function before making the PutItem call to DynamoDB, using KMS-backed envelope encryption via the AWS Encryption SDK (the option names it “Database Encryption SDK,” but the intent is client-side encryption). The encrypted fields remain ciphertext in transit to DynamoDB and at rest inside DynamoDB, satisfying both “in transit” and “at rest” with encryption happening prior to storage.

Option B only ensures DynamoDB encryption at rest at the service level, but the data would still be plaintext in the item attributes as seen by the application and anyone with DynamoDB read permissions (even though stored encrypted on disk). It does not guarantee “encrypted before stored.”

Option C encrypting after the write via streams is too late: plaintext would already be stored (and potentially accessed) before post-processing.

Option D adds unnecessary workflow complexity. Encrypting in a queue still requires encryption before DynamoDB, but it does not inherently simplify compared to encrypting directly in the Lambda that writes to DynamoDB.

Therefore, client-side encryption in Lambda using KMS-backed encryption is the correct solution.