What is Presto.exe?
Presto.exe is the main executable for Presto Desktop, an AI assistant for radiologists that integrates with dictation systems like Nuance PowerScribe 360 and PowerScribe One. This page exists so that IT administrators and security teams who encounter the file can quickly identify it.
Quick facts
Section titled “Quick facts”| Field | Value |
|---|---|
| File name | Presto.exe |
| Publisher | HOPPR (IntellixAI, Inc.) |
| Product | Presto |
| Description | AI assistant for radiologists |
| Install location | %LOCALAPPDATA%\Presto\Presto.exe (per-user, no admin rights) |
| Code signing | DigiCert Extended Validation (EV) code signing certificate |
| Compliance | HIPAA compliant (BAA available) |
| Vendor website | https://presto.run |
| Support contact | support@presto.run |
What does it do?
Section titled “What does it do?”Presto Desktop runs in the system tray and bridges AI radiology analysis with existing clinical desktop applications (PowerScribe 360, PowerScribe One). It uses Windows accessibility APIs to read draft reports and inject AI-generated findings back into the dictation workflow. End users authenticate to the Presto backend via a passwordless one-time code emailed to their work address.
Where is it installed?
Section titled “Where is it installed?”By default, Presto.exe lives at:
%LOCALAPPDATA%\Presto\Presto.exeThis is a per-user installation — no administrator privileges are required to install or run it. The installer (Presto-Setup.exe) is documented separately at What is Presto-Setup.exe?.
User configuration is stored at %APPDATA%\Presto\config.json. OAuth tokens are stored in the Windows Credential Manager, not on disk.
An operational log is written to %APPDATA%\Presto\presto.log. It is kept for the current day: every session relaunched on the same calendar day appends to the same file, so a crash followed by a relaunch does not erase the entries needed to diagnose the crash. On the first launch of a new day the previous day’s log is wiped. The log holds diagnostic events only — no clinical data is written to it.
Is it safe?
Section titled “Is it safe?”Presto.exe is signed with a DigiCert Extended Validation (EV) code signing certificate, which Windows SmartScreen treats as a trusted publisher. The signature is timestamped to remain valid beyond certificate expiry.
- All network traffic uses TLS 1.2 or later (TLS 1.3 preferred)
- No clinical data is persisted locally
- No bundled API keys or secrets — all credentials flow through the authenticated backend
- Software updates are cryptographically verified (Ed25519 + SHA-256) before installation
For the full security posture, see the Security & Compliance page.
Network endpoints
Section titled “Network endpoints”Presto.exe communicates with the following domains over HTTPS only:
| Domain | Purpose |
|---|---|
app.presto.run | Authentication and backend API |
*.app.presto.run | Organization-specific tenant backend |
releases.app.presto.run | Software update downloads |
If your firewall or proxy blocks any of these, the application will not be able to authenticate or fetch updates.
How is it deployed?
Section titled “How is it deployed?”Most organizations deploy Presto via the silent installer using Microsoft Intune, SCCM, or similar fleet-management tooling. End users can also install it themselves from https://app.presto.run/download/ without administrator rights.
Got a question or want to verify the file?
Section titled “Got a question or want to verify the file?”Contact support@presto.run with the SHA-256 hash of the file you have, and we will confirm it matches an official release. You can compute it with:
Get-FileHash -Algorithm SHA256 "$env:LOCALAPPDATA\Presto\Presto.exe"Right-click the file → Properties → Digital Signatures to verify it is signed by IntellixAI, Inc.