Herpes zoster is an acute herpetic skin disease caused by varicel-la-zoster virus (VZV) in which the nerve damage is mainly inflammatory demyelinating changes. Postherpetic neuralgia (PHN) is a persistent, prolonged pain that persists even after the rash has healed. Approximately 20% of patients with shingles will have residual neuralgia. The risk increases with age, and the incidence of shingles and its sequelae will continue to increase as the world’s population ages. A small number of patients suffer from chronic pain, heavy psychological burden, depression, sleep disorders, poor quality of life, and reduced or even lost ability to work and socialize, resulting in loss of confidence in life and thoughts of living lightly. The etiology of postherpetic neuralgia has not yet been fully elucidated. One view is that it is mainly a local inflammatory response rather than a disruption of nerve axons, which involves the regulation of the fast sodium channel mRNA and causes abnormal firing and thus pain. Another view is that the occurrence of postherpetic neuralgia is related to damage to nerve fibers in the posterior roots of the patient’s spinal cord and finds that nerve damage in herpes zoster is an inflammatory demyelinating change, a process that is reversible. The elderly are prone to postherpetic neuralgia and its duration is longer due to tissue degeneration, reduced function of repairing nerves, and slower process of nerve tissue repair. There is a lack of satisfactory treatment for postherpetic neuralgia. Modern medicine commonly uses antiviral drugs, analgesics and vitamins, astringent drugs, neuroactive drugs, and neurosurgical methods. Although the disease can be controlled to varying degrees, long-term use of drugs can produce gastrointestinal adverse effects or dependence, and surgery also has the risk of causing mild hemiparesis and sensory deficits. Chinese medicine has recorded the names and treatments related to herpes zoster as early as the Han Dynasty, and its theories and therapies have been developed and refined to this day. The dialectical evidence of postherpetic neuralgia is mainly qi stagnation and blood stagnation, and meridians and channels are not accessible. There are various methods of acupuncture treatment for this disease, among which fire acupuncture is the most effective, especially in pain relief, stopping herpes and posterior neuralgia, etc. It is significantly better than other therapies. Fire acupuncture stimulation is more intense, can regulate the qi and remove blood stasis, to achieve the “pass is not pain” effect; fire acupuncture therapy also has a heat to induce heat, the role of muscle convergence sores, can adjust the function of the internal organs meridians. Therefore, fire acupuncture is effective in treating post-herpetic neuralgia, promoting the recovery of damaged nerves in the later stages of herpes zoster, reducing pain caused by abnormal nerve discharge, and improving the quality of life of patients. It is convenient to obtain materials, simple to operate, safe and effective, and suitable for clinical promotion and application.