Objective To analyze the clinical efficacy of acupuncture and moxibustion three-way method in the treatment of acute herpes zoster. Methods A total of 100 patients with acute herpes zoster admitted to our hospital from July 2020 to May 2021 were randomly divided into treatment group (56 patients) and control group (44 patients). The treatment group was treated with fire needle, bloodletting cupping and filiform needle surround needling. The control group was treated with pregabalin capsule and cobamamide tablets. The clinical efficacy, pain, blistering, crusting and decrustation time and SDS depression score were compared between the two groups. Results The total effective rate of the treatment group was higher than that of the control group, and the difference was statistically significant (P