Postherpetic neuralgia is a painful condition that is one of the most common complications of an acute herpes zoster infection. It presents as a localised rash resembling chicken pox, often called 'shingles'. Postherpetic neuralgia may persist until death and has major implications for quality of life and use of healthcare resources. Corticosteroids have a potent anti-inflammatory action which might minimise nerve damage and thereby relieve or prevent the pain of people suffering from this condition. Five trials were included in the review. There was no significant difference between the corticosteroid and control groups in the presence of postherpetic neuralgia six months after the onset of acute herpetic rash. There was also no significant difference between the treatment groups and placebo groups in the secondary outcome analyses and subgroup analyses. It can be concluded that corticosteroids are ineffective in preventing postherpetic neuralgia. No significant adverse events were noted in patients with shingles taking prednisolone. Corticosteroids used for other indications during acute zoster infection appear to be as safe as when no infection is present.