Postherpetic neuralgia is a complication following 10% of herpes zoster infections. It is a complex pain syndrome, thought to be driven by peripheral factors and central nervous system sensitisation. Herpes zoster is common in South Africa. It is important to identify high-risk patients and intervene early to reduce the likelihood and severity of postherpetic neuralgia (PHN). This review discusses a stepwise approach to the treatment of PHN in primary care.