Shingles are triggered by the reactivation of an infection with the varicella zoster virus (VZV) and are characterized by specific vesicular skin lesions. Mostly, elderly patients are affected. Depending on the affected dermatome, some serious complications can be observed. The introduction of a vaccine against shingles in Germany offers a great potential for reducing the frequency and severity of this disease. There are both a live vaccine, which is no longer recommended, and an inactivated vaccine, which, however, is still not sufficiently recommended to the authorized patient groups and is also only available to a limited extent due to delivery bottlenecks. HZ neuralgia is a serious complication of the disease that requires rapid and effective therapy and should be handed over to experienced pain therapists rather too early than too late. Unfortunately, in everyday clinical practice only a few people are familiar with VZV vasculopathy, which is associated with a significantly increased risk of cerebral insults. Ein Herpes zoster wird durch die endogene Reaktivierung einer Varizella-zoster-Virus-Infektion ausgelost. Ziel der medikamentosen Therapie des Herpes zoster und der Impfung gegen Herpes zoster mit Totimpfstoff ist die Reduktion der postherpetischen Neuralgie als gefurchtete Komplikation. Themen dieses Artikels sollen pathophysiologische Faktoren, Informationen rund um die Impfung gegen Herpes zoster, die Zoster-Neuralgie sowie die durch das Virus getriggerte Vaskulitis/Vaskulopathie sein.