Varicella zoster virus (VZV) infection is a relatively common viral infection of the cranial nerves, especially the trigeminal and facial nerves. However, the involvement of the isolated vagus nerve has been rarely reported. We report a 65-year-old man with isolated vagus nerve palsy after a VZV infection. He presented with headache, dysphagia and hoarseness with sudden onset. He had vesicles localized on the concha of the right ear. The VZV IgG and IgM antibody titer in the serum was elevated.