Can I secure SQL Server symmetric key from [sa] account? Can I create symmetric key using local user certificate via MMC?
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Can I secure SQL Server symmetric key from [sa] account?
Nope. The best you can do (and should be doing) is to:
However, SA is just a login. The server roles of sysadmins gives full privileges over the system.
The only way to secure a symmetric key using SQL Server against a sysadmins is to use multiple encryption techniques involving the users and/or the application.
Note that always encrypted and HSMs use Asymmetric keys.
Can I create symmetric key using local user certificate via MMC?
That's not going to help you with this issue.