Objective To explore the effect of repeated shallow fire-needling combined with blood-letting therapy in the treatment of acute herpes zoster. Methods Atotal of 60 patients with acute herpes zoster admitted to our hospital from January 2020 to January 2023 were selected as the study subjects. They were divided into observation group and control group by random number table method, with 30 patients in each group. The control group was treated with conventional antiviral drugs, and the observation group was treated with repeated shallow fre-needling combined with blood-letting therapy on the basis of the control group. The symptom relief, pain degree, inflammatory factor level and the incidence of sequelae were compared between the two groups. Results The pain relief time and pain duration in the observation group were shorter than those in the control group (P<0.05). The pain degree of the two groups after 7 and 10 days of treatment was lower than that before treatment, and that in the observation group was lower than that in the control group, the diference was statistically signifcant (P<0.05). After treatment, the levels of IL-6 and TNF-α in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group, the diferences were statistically signifcant (P<0.05). The incidence of postherpetic neuralgia in the observation group was 13.33%, which was lower than 43.33% in the control group, the diference was statistically signifcant (P<0.05). Conclusion On the basis of conventional antiviral therapy, repeated shallow fire-needling combined with blood- letting therapy can further improve the symptoms and signs of acute herpes zoster, quickly reduce the pain degree, and reduce the infammatory response state.