Live-attenuated zoster vaccine (LZV) and adjuvanted recombinant zoster vaccine (RZV) have been approved for use in China. This study aimed to evaluate and compare the cost-effectiveness of these two herpes zoster (HZ) vaccination strategies in a birth cohort of individuals aged 50 years. The cost-effectiveness of RZV and LZV was compared to no vaccination strategy using a lifetime Markov model from a societal perspective. Model parameters were obtained from up-to-date published literature and statistical data. The costs associated with vaccination and medical treatment, quality-adjusted life years (QALYs), the number of herpes zoster and related complication cases averted, and the incremental cost-effectiveness ratio (ICER) were calculated. Sensitivity analyses were performed to assess the robustness of the results. Compared to the no-vaccination strategy, the RZV strategy was estimated to prevent 4,126 HZ cases and 772 postherpetic neuralgia (PHN) cases, while the LZV strategy was estimated to avert 2,355 HZ cases and 467 PHN cases. The ICER was estimated at 711.46 US $/QALY and 914.62 US $/QALY for the RZV and LZV strategies, respectively. HZ vaccination could provide significant health benefits at a reasonable cost. RZV was predicted to be more cost-effective than LZV.