Insufficient coverage of herpes zoster vaccination is a challenge faced by China. This study explores herpes zoster vaccination coverage, willingness, and their predictive factors among individuals aged 50 and above in Ningbo City, aiming to formulate evidence-based health education intervention strategies.From March to June 2024, a questionnaire survey was conducted using a multi-stage sampling method on permanent residents aged 50 years and above in Ningbo City. Rao-Scott chi-square test and logistic regression analyzed predictors of herpes zoster vaccination coverage and willingness. Findings revealed a 1.21% vaccination rate, with 36.05% willing but unvaccinated. Among those not vaccinated, key barriers included lack of awareness (48.20%), perceived low risk (28.22%), and cost concerns (15.90%). Logistic regression identified lower coverage among non-civil servants and higher coverage among those with coresidence with adult children, monthly income ≥US$685USD, near-good self-rated health, herpes zoster knowledge score ≥14, and medical staff recommendations. Lower willingness was seen in those aged 60 and above ( < .05 for 59 years old and below), with immune disorders, vaccine-targeted disease history, and below-good self-rated health ( < .05 for self-rated their health as good). Higher willingness was linked to high school diploma or higher, monthly income ≥US$685, herpes zoster knowledge score ≥ 14, and medical staff recommendations. It is recommended to strengthen the publicity and education on the awareness and effectiveness of the herpes zoster vaccine among this group, particularly through channels through which they typically access vaccine information, and enhance the role of medical staff and family member in advocating for vaccination.