We analysed prospectively the medical, societal and economic burden among patients from 18 general practices in East London, serving 158,716 patients who presented to their general practitioners with acute Herpes Zoster over an 8-month period. One hundred and eighty-six patients with HZ were seen by GPs during the study period, of whom 96 were referred, 70 enrolled and 65 completed. PHN occurred in 13.4% of patients. The average overall cost of HZ in the first 6 months was calculated at pound524 per patient. Medical costs were highest in those aged over 65 and societal costs highest in those aged under 65 years.