〔Abstract〕 Objective To observe the efficacy and safety of Lingnan fire needle combined with gabapentin capsule in the treatment of postherpetic neuralgia (PHN). Methods A total of 67 PHN patients treated in the outpatient and inpatient department of Acupuncture and moxibustion Department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from April 2019 to April 2020 were selected and randomly assigned to an observation group and a control group by random number table method, with 31 cases in the observation group and 36 cases in the control group. The control group was treated with gabapentin capsule only, and the observation group was treated with fire needle combined with gabapentin capsule. The clinical efficacy of the two groups was compared. Results The visual analogue scale (VAS) score on the 5th day of treatment in the observation group was lower than that of the control group, and the days of VAS score decline ≥ 30% and VAS score decline ≥ 50% were shorter than those of the control group, the differences were statistically significant (P < 0.05). The total effective rate of the observation group was 90.32 %, higher than 80.56 % of the control group, the difference was statistically significant (P < 0.05). There was no significant difference in pain area and the leeds assessment of neuropathic symptoms and sign (LANSS) score between the two groups on the 5th and 11th day (P > 0.05). The ID Pain score of the observation group was lower than that of the control group on 5th day, the difference was statistically significant (P < 0.05); However, there was no significant difference in ID Pain score between the two groups on the 11th day (P > 0.05). The total dose of gabapentin in the observation group was 10500 (10200,12000) mg, which was lower than 11700 (10200,12300) mg in the control group, and the difference was statistically significant (P < 0.05). The incidence of adverse reactions in the observation group was 22.60 %, lower than that in the control group (63.90%), and the difference was statistically significant (P < 0.05). The scores of role physical (RP), bodily pain (BP), social function (SF) and role emotional (RE) in the observation group were higher than those in the control group on 5th day, with statistical significance (P < 0.05). Conclusion Lingnan fire needle intervention can significantly shorten the time of pain relief for PHN, improve symptoms in the short term, shorten the cost of treatment time, improve the quality of life and increase safety.