OBJECTIVE： To investigate the clinical efficacy and safety of high-dose valaciclovir combined with acupuncture in the treatment of herpes zoster. METHODS： 194 patients with herpes zoster were divided into control group and observation group according to random number table method， with 97 cases in each group. Control group was given acupuncture treatment； observation group was additionally given Valaciclovir hydrochlordide tablet 0.3 g， bid， based on control group. Both group received treatment for 10 d. Clinical efficacy and the time of clinical symptoms improvement were observed in 2 groups as well as VAS score and substance P level before and after treatment. The occurrence of postherpetic neuralgia and ADR were also observed in 2 groups. RESULTS： Total effective rate of observation group was 97.9％， which was significantly higher than 90.7％ of control group， with statistical significance （P＜0.05）. The analgesic time， stopping herpes time， lesion scabby time， lesion disappeared time of observation group were significantly shorter than those of control group， with statistical significance （P＜0.05）. There was no statistical significance in VAS score and substance P level between 2 groups before treatment （P＞0.05）； those of 2 groups were decreased significantly after treatment， and the observation group was lower than the control group， with statistical significance （P＜0.05）. The incidence of postherpetic neuralgia in observation group was 14.4％， which was significantly lower than 28.9％ of control group， with significant difference （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： High-dose valacyclovir combined with acupuncture can effectively treat herpes zoster， with advantages of analgesic effect， rapid lesions recovery， low rate of postherpetic neuralgia with good safety.