Background: Herpes zoster (HZ), or shingles, is a painful reactivation of the varicella-zoster virus, with increased risk in older adults and immunocompromised individuals. Despite the availability of effective vaccines like the recombinant zoster vaccine (Shingrix®), uptake remains low in many countries, including Saudi Arabia. This study assessed awareness, attitudes, and acceptance of the HZ vaccine among adults in Tabuk, Saudi Arabia. Methods: A cross-sectional survey was conducted in February 2024 among 446 adults aged ≥18 years using a structured, self-administered questionnaire. The survey assessed demographics, knowledge of HZ and its vaccine, attitudes toward prevention, and willingness to vaccinate. Data were analyzed using SPSS version 25.0, with chi-square tests and ordinal logistic regression to identify predictors of HZ awareness. Results: Of the 446 participants, 75.6% were aware of HZ, yet only 48.0% knew of the vaccine, and a mere 5.7% had been vaccinated. Knowledge gaps included misconceptions about HZ transmission and vaccine purpose. Occupation in the medical/healthcare field was the strongest predictor of higher HZ knowledge (OR = 4.404, p < 0.001). While only 28.8% expressed concern about contracting HZ, 82.5% reported willingness to receive the vaccine if recommended by a healthcare provider. Lack of awareness was the leading barrier to vaccination (94.3%). Conclusion: Despite moderate awareness of HZ, vaccine knowledge and uptake remain suboptimal among adults in Tabuk. However, high willingness to vaccinate upon provider recommendation highlights an opportunity for targeted educational campaigns and strengthened provider engagement to improve vaccine coverage and reduce the burden of HZ in Saudi Arabia.