diff --git a/nixos/doc/manual/from_md/release-notes/rl-2205.section.xml b/nixos/doc/manual/from_md/release-notes/rl-2205.section.xml
index 9cf27e56827a..ede0e10e0346 100644
--- a/nixos/doc/manual/from_md/release-notes/rl-2205.section.xml
+++ b/nixos/doc/manual/from_md/release-notes/rl-2205.section.xml
@@ -1286,6 +1286,15 @@
           been added by default.
         </para>
       </listitem>
+      <listitem>
+        <para>
+          <literal>security.pam.ussh</literal> has been added, which
+          allows authorizing PAM sessions based on SSH
+          <emphasis>certificates</emphasis> held within an SSH agent,
+          using
+          <link xlink:href="https://github.com/uber/pam-ussh">pam-ussh</link>.
+        </para>
+      </listitem>
       <listitem>
         <para>
           The <literal>zrepl</literal> package has been updated from
diff --git a/nixos/doc/manual/release-notes/rl-2205.section.md b/nixos/doc/manual/release-notes/rl-2205.section.md
index 58a1b23d17bf..90ac7e90e729 100644
--- a/nixos/doc/manual/release-notes/rl-2205.section.md
+++ b/nixos/doc/manual/release-notes/rl-2205.section.md
@@ -470,6 +470,8 @@ In addition to numerous new and upgraded packages, this release has the followin
 - `services.logrotate.enable` now defaults to true if any rotate path has
   been defined, and some paths have been added by default.
 
+- `security.pam.ussh` has been added, which allows authorizing PAM sessions based on SSH _certificates_ held within an SSH agent, using [pam-ussh](https://github.com/uber/pam-ussh).
+
 - The `zrepl` package has been updated from 0.4.0 to 0.5:
 
   - The RPC protocol version was bumped; all zrepl daemons in a setup must be updated and restarted before replication can resume.
diff --git a/nixos/modules/security/pam.nix b/nixos/modules/security/pam.nix
index c0ef8b5f30bd..f9697d61f1b2 100644
--- a/nixos/modules/security/pam.nix
+++ b/nixos/modules/security/pam.nix
@@ -61,6 +61,19 @@ let
         '';
       };
 
+      usshAuth = mkOption {
+        default = false;
+        type = types.bool;
+        description = ''
+          If set, users with an SSH certificate containing an authorized principal
+          in their SSH agent are able to log in. Specific options are controlled
+          using the <option>security.pam.ussh</option> options.
+
+          Note that the  <option>security.pam.ussh.enable</option> must also be
+          set for this option to take effect.
+        '';
+      };
+
       yubicoAuth = mkOption {
         default = config.security.pam.yubico.enable;
         defaultText = literalExpression "config.security.pam.yubico.enable";
@@ -475,6 +488,9 @@ let
           optionalString cfg.usbAuth ''
             auth sufficient ${pkgs.pam_usb}/lib/security/pam_usb.so
           '' +
+          (let ussh = config.security.pam.ussh; in optionalString (config.security.pam.ussh.enable && cfg.usshAuth) ''
+            auth ${ussh.control} ${pkgs.pam_ussh}/lib/security/pam_ussh.so ${optionalString (ussh.caFile != null) "ca_file=${ussh.caFile}"} ${optionalString (ussh.authorizedPrincipals != null) "authorized_principals=${ussh.authorizedPrincipals}"} ${optionalString (ussh.authorizedPrincipalsFile != null) "authorized_principals_file=${ussh.authorizedPrincipalsFile}"} ${optionalString (ussh.group != null) "group=${ussh.group}"}
+          '') +
           (let oath = config.security.pam.oath; in optionalString cfg.oathAuth ''
             auth requisite ${pkgs.oathToolkit}/lib/security/pam_oath.so window=${toString oath.window} usersfile=${toString oath.usersFile} digits=${toString oath.digits}
           '') +
@@ -926,6 +942,96 @@ in
       };
     };
 
+    security.pam.ussh = {
+      enable = mkOption {
+        default = false;
+        type = types.bool;
+        description = ''
+          Enables Uber's USSH PAM (<literal>pam-ussh</literal>) module.
+
+          This is similar to <literal>pam-ssh-agent</literal>, except that
+          the presence of a CA-signed SSH key with a valid principal is checked
+          instead.
+
+          Note that this module must both be enabled using this option and on a
+          per-PAM-service level as well (using <literal>usshAuth</literal>).
+
+          More information can be found <link
+          xlink:href="https://github.com/uber/pam-ussh">here</link>.
+        '';
+      };
+
+      caFile = mkOption {
+        default = null;
+        type = with types; nullOr path;
+        description = ''
+          By default <literal>pam-ussh</literal> reads the trusted user CA keys
+          from <filename>/etc/ssh/trusted_user_ca</filename>.
+
+          This should be set the same as your <literal>TrustedUserCAKeys</literal>
+          option for sshd.
+        '';
+      };
+
+      authorizedPrincipals = mkOption {
+        default = null;
+        type = with types; nullOr commas;
+        description = ''
+          Comma-separated list of authorized principals to permit; if the user
+          presents a certificate with one of these principals, then they will be
+          authorized.
+
+          Note that <literal>pam-ussh</literal> also requires that the certificate
+          contain a principal matching the user's username. The principals from
+          this list are in addition to those principals.
+
+          Mutually exclusive with <literal>authorizedPrincipalsFile</literal>.
+        '';
+      };
+
+      authorizedPrincipalsFile = mkOption {
+        default = null;
+        type = with types; nullOr path;
+        description = ''
+          Path to a list of principals; if the user presents a certificate with
+          one of these principals, then they will be authorized.
+
+          Note that <literal>pam-ussh</literal> also requires that the certificate
+          contain a principal matching the user's username. The principals from
+          this file are in addition to those principals.
+
+          Mutually exclusive with <literal>authorizedPrincipals</literal>.
+        '';
+      };
+
+      group = mkOption {
+        default = null;
+        type = with types; nullOr str;
+        description = ''
+          If set, then the authenticating user must be a member of this group
+          to use this module.
+        '';
+      };
+
+      control = mkOption {
+        default = "sufficient";
+        type = types.enum [ "required" "requisite" "sufficient" "optional" ];
+        description = ''
+          This option sets pam "control".
+          If you want to have multi factor authentication, use "required".
+          If you want to use the SSH certificate instead of the regular password,
+          use "sufficient".
+
+          Read
+          <citerefentry>
+            <refentrytitle>pam.conf</refentrytitle>
+            <manvolnum>5</manvolnum>
+          </citerefentry>
+          for better understanding of this option.
+        '';
+      };
+    };
+
     security.pam.yubico = {
       enable = mkOption {
         default = false;
@@ -1110,6 +1216,9 @@ in
       optionalString (isEnabled (cfg: cfg.usbAuth)) ''
         mr ${pkgs.pam_usb}/lib/security/pam_usb.so,
       '' +
+      optionalString (isEnabled (cfg: cfg.usshAuth)) ''
+        mr ${pkgs.pam_ussh}/lib/security/pam_ussh.so,
+      '' +
       optionalString (isEnabled (cfg: cfg.oathAuth)) ''
         "mr ${pkgs.oathToolkit}/lib/security/pam_oath.so,
       '' +
diff --git a/nixos/modules/security/sudo.nix b/nixos/modules/security/sudo.nix
index 99e578f8adae..4bf239fca8f9 100644
--- a/nixos/modules/security/sudo.nix
+++ b/nixos/modules/security/sudo.nix
@@ -245,7 +245,7 @@ in
 
     environment.systemPackages = [ sudo ];
 
-    security.pam.services.sudo = { sshAgentAuth = true; };
+    security.pam.services.sudo = { sshAgentAuth = true; usshAuth = true; };
 
     environment.etc.sudoers =
       { source =
diff --git a/nixos/tests/all-tests.nix b/nixos/tests/all-tests.nix
index 043d8a56d0c6..1ed12c54c575 100644
--- a/nixos/tests/all-tests.nix
+++ b/nixos/tests/all-tests.nix
@@ -388,6 +388,7 @@ in
   pam-file-contents = handleTest ./pam/pam-file-contents.nix {};
   pam-oath-login = handleTest ./pam/pam-oath-login.nix {};
   pam-u2f = handleTest ./pam/pam-u2f.nix {};
+  pam-ussh = handleTest ./pam/pam-ussh.nix {};
   pantalaimon = handleTest ./matrix/pantalaimon.nix {};
   pantheon = handleTest ./pantheon.nix {};
   paperless-ng = handleTest ./paperless-ng.nix {};
diff --git a/nixos/tests/pam/pam-ussh.nix b/nixos/tests/pam/pam-ussh.nix
new file mode 100644
index 000000000000..ba0570dbf97d
--- /dev/null
+++ b/nixos/tests/pam/pam-ussh.nix
@@ -0,0 +1,70 @@
+import ../make-test-python.nix ({ pkgs, lib, ... }:
+
+let
+  testOnlySSHCredentials = pkgs.runCommand "pam-ussh-test-ca" {
+    nativeBuildInputs = [ pkgs.openssh ];
+  } ''
+    mkdir $out
+    ssh-keygen -t ed25519 -N "" -f $out/ca
+
+    ssh-keygen -t ed25519 -N "" -f $out/alice
+    ssh-keygen -s $out/ca -I "alice user key" -n "alice,root" -V 19700101:forever $out/alice.pub
+
+    ssh-keygen -t ed25519 -N "" -f $out/bob
+    ssh-keygen -s $out/ca -I "bob user key" -n "bob" -V 19700101:forever $out/bob.pub
+  '';
+  makeTestScript = user: pkgs.writeShellScript "pam-ussh-${user}-test-script" ''
+    set -euo pipefail
+
+    eval $(${pkgs.openssh}/bin/ssh-agent)
+
+    mkdir -p $HOME/.ssh
+    chmod 700 $HOME/.ssh
+    cp ${testOnlySSHCredentials}/${user}{,.pub,-cert.pub} $HOME/.ssh
+    chmod 600 $HOME/.ssh/${user}
+    chmod 644 $HOME/.ssh/${user}{,-cert}.pub
+
+    set -x
+
+    ${pkgs.openssh}/bin/ssh-add $HOME/.ssh/${user}
+    ${pkgs.openssh}/bin/ssh-add -l &>2
+
+    exec sudo id -u -n
+  '';
+in {
+  name = "pam-ussh";
+  meta.maintainers = with lib.maintainers; [ lukegb ];
+
+  machine =
+    { ... }:
+    {
+      users.users.alice = { isNormalUser = true; extraGroups = [ "wheel" ]; };
+      users.users.bob = { isNormalUser = true; extraGroups = [ "wheel" ]; };
+
+      security.pam.ussh = {
+        enable = true;
+        authorizedPrincipals = "root";
+        caFile = "${testOnlySSHCredentials}/ca.pub";
+      };
+
+      security.sudo = {
+        enable = true;
+        extraConfig = ''
+          Defaults lecture="never"
+        '';
+      };
+    };
+
+  testScript =
+    ''
+      with subtest("alice should be allowed to escalate to root"):
+        machine.succeed(
+            'su -c "${makeTestScript "alice"}" -l alice | grep root'
+        )
+
+      with subtest("bob should not be allowed to escalate to root"):
+        machine.fail(
+            'su -c "${makeTestScript "bob"}" -l bob | grep root'
+        )
+    '';
+})
diff --git a/pkgs/os-specific/linux/pam_ussh/default.nix b/pkgs/os-specific/linux/pam_ussh/default.nix
index 499239500acc..889c8bc6f57c 100644
--- a/pkgs/os-specific/linux/pam_ussh/default.nix
+++ b/pkgs/os-specific/linux/pam_ussh/default.nix
@@ -2,6 +2,7 @@
 , fetchFromGitHub
 , pam
 , lib
+, nixosTests
 }:
 
 buildGoModule rec {
@@ -54,6 +55,8 @@ buildGoModule rec {
     runHook postInstall
   '';
 
+  passthru.tests = { inherit (nixosTests) pam-ussh; };
+
   meta = with lib; {
     homepage = "https://github.com/uber/pam-ussh";
     description = "PAM module to authenticate using SSH certificates";