Herpes zoster is a viral disease that affects both nerves and skin. Skin damage and accompanying neuralgia are characteristic of the disease. The characteristics of the onset of herpes zoster vary according to age. In a study of 169 patients with herpes zoster, it was reported that in those aged less than or equal to 30 years, the rash occurred first and localized itching or mild localized pain was felt only 2-3 days later; in those aged greater than or equal to 40 years, neuralgia symptoms appeared before the rash, often 5-7 days earlier in elderly patients, and their pain and suffering increased in length with the appearance of the rash. Because of the late appearance of the rash in elderly patients with herpes zoster, it is easy to be misdiagnosed, such as upper limb pain as cervical spondylosis, paroxysmal pain in the chest as coronary heart disease or intercostal neuralgia; severe pain in the abdomen is often misdiagnosed as urinary calculi or intestinal spasm because of the lack of obvious pressure and rebound pain. Herpes in the forehead is not diagnosed as glaucoma or other eye diseases because of migraine, eye pain, conjunctival congestion and tearing, and blurred vision; herpes in the ear is easily misdiagnosed as intracranial disease because of tinnitus, hearing loss, vertigo, headache, or nausea and vomiting, which are similar to increased intracranial pressure. In general, the older the elderly person with herpes zoster, the more severe the skin damage and neuralgia. Untimely or inappropriate treatment can cause a variety of hazards, such as patients can be left with intractable neuralgia. Herpes zoster of the ear is often associated with internal dysfunction, leading to hearing impairment. Facial paralysis can occur if the geniculate ganglion is involved. Herpes zoster of the eye can cause acute and chronic inflammation in various parts of the eye, which can lead to blindness due to scar formation. Herpes zoster in the elderly should be diagnosed early, and once localized itching and pain in the skin occurs, a hospital visit should be made for examination. Antiviral treatment and symptomatic treatment should be given immediately after diagnosis. This will reduce complications and prevent posterior neuralgia. Commonly used acyclovir, ganciclovir is effective antiviral and shortens the course of the disease. For older patients with larger lesions and more severe disease, they should be hospitalized for comprehensive treatment.