Abstract： Objective： To observe the clinical effect of fire needling and cotton moxibustion combined with Chinese medicinal on herpes zoster of heat constraint in the liver channel type. Methods： A total of 90 patients with herpes zoster of heat constraint in the liver channel type treated at Shaoguan Hospital of Chinese Medicine from January 2022 to December 2023 were selected as the observation subjects. They were randomly divided into the control group 1，the control group 2，and the study group using a random number table method，with 30 patients in each group. The control group 1 was treated with simple western medicine， the control group 2 was treated with simple Longdan Xiegan Decoction， and the study group was treated with fire needling and cotton moxibustion combined with Longdan Xiegan Decoction. Compared the clinical effects of three groups， as well as the recovery of rash， pain [Visual Analogue Scale (VAS)]， and incidence of postherpetic neuralgia before and after treatment. Results：The total effective rates were 96.67%， 76.67%， and 56.67% in the study group， the control group 1， and the control group 2， respectively；the total effective rate in the study group was higher than those in the control group 1 and the control group 2 (P＜0.05)， and there was no significant difference between the control group 1 and the control group 2 (P＞0.05). The study group had shorter blister stopping time， scab formation time， and scab removal time than the control group 1 and the control group 2，differences being significant (P＜0.05). After treatment，the VAS scores of pain in all the three groups were decreased when compared with those before treatment (P＜0.05)， and the VAS scores of pain in the study group were lower than those in the control group 1 and the control group 2 (P＜0.05)； there was no significant difference in VAS scores between the control group 1 and the control group 2 (P＞0.05). One month after the end of treatment，the incidence of postherpetic neuralgia in the study group，the control group 1，and the control group 2 were 6.67%， 33.33%， and 43.33%， respectively； the incidence of postherpetic neuralgia in the study group was lower than those in the control group 1 and the control group 2 (P＜0.05)， and there was no significant difference between the control group 1 and the control group 2 (P＞0.05). Conclusion： Fire needling and cotton moxibustion combined with Longdan Xiegan Decoction for herpes zoster is more effective than Chinese medicine or western medicine alone. It can shorten the time for patients to stop blisters and effectively reduce the incidence of postherpetic neuralgia.