The pain associated with acute herpes zoster is neuropathic. In this case report, we describe acute herpes zoster patients with severe pain, allodynia, and hyperesthesia over the T1 to T8 dermatomes. Patients received continuous epidural administration of ketamine at a dose of 20 mg with 0.125% bupivacaine at a dose of 110 ml for 2 days. Their acute herpes zoster pain was controlled without any sign of side effects. This case report, epidural blocks with ketamine, an antagonist of the N-methyl-D-aspartic acid receptor and bupivacaine effectively in treated acute herpes zoster pain, when applied soon after the onset of the acute phase of the disease.