The burden of illness from herpes zoster and postherpetic neuralgia is quite high both to the affected patients and to the society. The incidence and severity of herpes zoster and postherpetic neuralgia increase with age in association with a decline in cell mediated immunity to varicella zoster virus. Antiviral agents have been shown to be effective in reducing the morbidity of herpes zoster. Zoster associated pain should be treated early and aggressively, because it is more difficult to treat once established. Therefore, patients at a high risk of developing postherpetic neuralgia should be referred to pain clinic specialist earlier, rather than later. Varicella zoster virus vaccine has proven to be effective in reducing the incidence of herpes zoster and postherpetic neuralgia in older adults.