Background: The treatment of herpes zoster (HZ) by the traditional Chinese medicine of acupuncture is attracting attention. However, there is still a controversy about the effectiveness and safety of acupuncture treatment of HZ.Methods: Articles on randomized controlled trials examining acupuncture and Western medicine treatments of HZ published since the establishment of the PubMed, Embase, Medline, and Chinese Biomedical Literature (CBM) databases to March 2021 were electronically retrieved. The Cochrane System Evaluation Manual was used for the data analysis with Review Manager 5.3 software, and the Cochrane Handbook version 5.3 systematic review writing manual was adopted to evaluate the risk of bias.Results: In total, 11 articles, comprising 1,156 patients (585 in the experimental group and 571 in the control group) were included in the meta-analysis, and the results showed that the treatments used in the experimental and control groups were significant differences of total treatment efficiency [odds ratio (OR) =6.76; 95% confidence interval (CI): 3.46 to 13.21; P<0.