This study evaluated the efficacy and safety of stellate ganglion block (SGB) combined with trioxygen autologous blood retransfusion therapy (TABRT) in treating postherpetic neuralgia (PHN) of the head and face in elderly patients. A total of 190 patients (aged ≥ 60 years) with PHN were randomly assigned to receive either drug treatment alone (Group D, n = 40), drug treatment with SGB (Group DS, n = 52), drug treatment with TABRT (Group DT, n = 53), or drug combined SGB with TABRT (Group DST, n = 45). Key outcomes included pain visual analogue scale (VAS) scores and anxiety levels at baseline, 7 days, and 15 days post-treatment, the need for salvage analgesics, and complication rates assessed. All groups showed significant improvements in pain and anxiety, with greater reductions in the DS, DT, and DST groups compared to the drug-only group, and the combined therapy (DST) showing the most pronounced benefits. The DST group also had the highest proportion of patients not requiring rescue analgesics and the highest complete remission rate. Overall, the combination of SGB and TABRT was found to be effective and safe, offering superior therapeutic outcomes compared to single therapies for elderly patients with PHN of the head and face.