I recently had to work with FILESTREAM on a legacy project, which has a SQL Server database, and here are some notes.
Initially the request was to migrate the SQL Server database to a MySQL database, so that we could cut costs on hosting, however I quickly discovered this is not possible when FILESTREAM is being used.
FILESTREAM enables the SQL Db to stored unstructured data (e.g. documents, images, etc.), which is something most of our projects do not do. However, this was an old legacy project, and the client had chosen to not update the code/system in a long time. Most of our projects now store images on Azure Files, or a combination of AWS S3 and DynamoDb.
It seems there's limited support for FILESTREAM (not on AWS RDS), and that the easiest way is to store both the SQL database and web app on the same EC2 instance.
When importing a Db that uses FILESTREAM, there are a few extra steps to get it working and enable it:
Enabling FILESTREAM
On the Start menu, navigate to All Programs > SQL Server > Configuration Tools, and then select SQL Server Configuration Manager.
Note
On newer versions of Windows, follow these instructions to open SQL Server Configuration Manager.
In the list of services, right-click SQL Server Services, and then select Open.
In the SQL Server Configuration Manager snap-in, locate the instance of SQL Server on which you want to enable FILESTREAM.
Right-click the instance, and then select Properties.
In the SQL Server Properties dialog box, select the FILESTREAM tab.
Select the Enable FILESTREAM for Transact-SQL access check box.
If you want to read and write FILESTREAM data from Windows, select Enable FILESTREAM for file I/O streaming access. Enter the name of the Windows share in the Windows Share Name box.
If remote clients must access the FILESTREAM data that is stored on this share, select Allow remote clients to have streaming access to FILESTREAM data.
Select Apply.
In SQL Server Management Studio, select New Query to display the Query Editor.
In Query Editor, enter the following Transact-SQL code:
EXEC sp_configure filestream_access_level, 2; RECONFIGURE;
Select Execute.
Restart the SQL Server service.
References
https://learn.microsoft.com/en-us/sql/relational-databases/blob/enable-and-configure-filestream?view=sql-server-ver16