OBJECTIVES Incidence and severity of herpes zoster (HZ) increase with age. Postherpetic neuralgia (PHN) is its most common complication. The study objective was to assess the impact of HZ and PHN on daily life and quality of life (QoL) as perceived by the patient. METHODS A 12-month, longitudinal, observational study conducted on patients aged ≥50 years with acute HZ (eruptive phase), included by a representative sample of 644 French general practitioners (GP) between June 2007 and June 2008. Demographic and disease characteristics and treatment procedures were collected by the GP at the inclusion and at 3, 6 and 12 months. PHN and QoL assessments were performed by telephone interview of patients, at regular time points over 12 months, using comprehensive and validated questionnaires.  RESULTS A total of 1358 patients met the selection criteria and 1032 completed the follow-up. Mean age was 67.7±10.7 years (62.2% female). Mean time between rash onset and HZ diagnosis was 2.6±3.0 days. Most patients (94.1%) were treated with antiviral drugs. PHN prevalence at inclusion, 3, 6, and 12 months was 79.6%, 11.6%, 8.5%, and 6.6% respectively. Mean Zoster Brief Pain Inventory (ZBPI) interference score (range=0-10 worse) at inclusion, 3, 6 and 12 months was 3.1±2.4, 2.9±2.3, 2.5±2.1, 2.7±2.3 respectively, with main impact on general activity, sleep and mood. Throughout the 12-month study period, patients with persistent PHN presented lower scores on the physical (e.g. at 12 month: 39.7±13.7) and mental (43.6±11.3) component summaries of the 12-item short-form health survey (SF-12) than the patients without PHN, respectively 46.0±10.6 and 47.8±10.5. Moreover, univariate analysis found that among predictive factors at inclusion for PHN were a ZBPI score ≥5 (p<0.001) and a low SF-12 physical component summary (p<0.001). CONCLUSIONS This large cohort study confirms the HZ and PHN impact on daily life and quality of life, in spite of prompt diagnosis and antiviral treatment.