The most common site of shingles is the thoracic back, or the thoracic spinal nerves. If it occurs in the chest, especially in the skin area in the region of the third, fourth and fifth thoracic spinal ganglia, chest pain is often felt, but the nature of the pain is different from that of heart disease and other diseases. If chest pain occurs, other serious diseases should be ruled out first, especially myocardial infarction, angina pectoris or localized large artery entrapment, all of which can manifest as chest pain. Therefore, chest pain is more complex and is a manifestation of multiple diseases. If chest pain is caused by definite herpes zoster, other serious diseases still need to be excluded. The duration of pain varies from patient to patient, with some patients recovering from herpes in the acute phase and some patients having the disease for more than 1 month or even 3 months. If more than 3 months, it is postherpetic neuralgia. At this time, according to the neuropathic pain should be treated with medication, including sodium channel blockers, calcium channel blockers. If medication is not effective, local nerve block and neuromodulation can be performed in the pain department. The onset of herpes zoster has individual differences, if the onset of blistering is severe or no blistering before the pain is severe, we need to be vigilant about the occurrence of postherpetic neuralgia, early intervention, full amount, full course of antiviral and neuromodulatory drugs.