Objective To observe the clinical efficacy of acupuncture treatment in the elderly type 2 diabetes mellitus (T2DM) patients with coexisting herpes zoster. Methods A total of 80 elderly T2DM patients complicated with herpes zoster admitted in our department from January 2010 to January 2013 were enrolled in this study. They were randomly assigned to 2 matched groups (n＝40 for each group), that is, treatment and control groups. Treatment group was treated with body acupuncture recuperation together with local surrounding acupuncture treatments, while control group with western medicine. The curative effects were compared between the 2 groups by clinical symptoms and other relative indices. Results There were 31 cases in the treatment group getting completely recovered, 4 getting improved, 2 encountering failure and 3 cases still suffering from postherpetic neuralgia, with a total efficiency of 87.5 %. While in the control group, 20 patients completely recovered, 6 turned better, 10 failed, and 4 had postherpetic neuralgia, and the total efficiency was 65.0%, which was significant lower than that of the treatment group (P＜0.05). The healing times for scabbing and skin lesion subsiding were obviously shorter in the treatment group than in the control group (P＜0.05). After treatment, the treatment group had remarkably lower fasting and 2-hour postprandial blood glucoses than the control group (P＜0.05). Conclusion Acupuncture treatment is a better option in treatment of herpes zoster for the elderly T2DM patients.