Objective?To explore the clinical efficacy and immune function changes of ultrasound-guided stellate ganglion block (SGB) in the treatment of cephalic and facial acute herpes zoster (AHZ), to provide reference for clinical practice. Methods?A total of 50?patients with cephalic and facial AHZ diagnosed and treated at Shanghai Songjiang District Central Hospital from January 2018?to December 2019?were randomly divided into S group (25?cases, treated with blind probe SGB) and U group (25?cases, treated with ultrasound-guided SGB) according to the random number table method. The CD3+, CD4+, and CD8+ lymphocyte counts and plasma concentration of tumor necrosis factor-α（TNF-α），interleukin-1β（IL-1β），interleukin-10（IL-10）?in both groups of patients before and on the 7th day after treatment were tested, and the visual analog scale (VAS) and Quality of life (QOL)before and on the 7th, 14th, 21st and 28th day after treatment were evaluated, the effective rate of treatment was calculated, and adverse reactions were recorded during the treatment. Results?At 7, 14, 21?and 28?days after treatment, VAS scores in two?groups were lower than before, and VAS scores at 7, 14?and 21?days after treatment in U group were lower than those in S group (P<0.05). After treatment, the effective rate of U group was higher than that of S group (P<0.05). After 7, 14, 21?and 28?days of treatment, QOL scores of the two groups were significantly higher than before, and QOL scores of the U group were higher than those of the S group after 7, 14?and 21?days of treatment (P<0.05). After treatment, the percentages of CD3+ and CD4+T-lymphocytes in two?groups were higher than before treatment, and the percentages of CD8+T-lymphocytes were lower than before treatment, and the percentages of CD3+ and CD4+T-lymphocytes in U group were significantly higher than those in S group (P<0.05). After treatment, the levels of TNF-α and IL-1β were lower than before treatment, and the levels of IL-10?were higher than before treatment, and the levels of TNF-α and IL-1β in U group were lower than those in S group, and the levels of IL-10?in U group were higher than those in S group (P<0.05). There was no significant difference in the incidence of adverse reactions between two?groups (P>0.05). Conclusion?Ultrasound-guided SGB in the treatment of cephalic and facial AHZ can provide better analgesic effect, improve patients' quality of life, and promote the rapid recovery of patients' immune function, which is worthy of clinical application.