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As a classic vision task, anomaly detection has been widely applied in industrial inspection and medical imaging. In this task, data scarcity is often a frequently-faced issue. To solve it, the few-shot anomaly detection (FSAD) scheme is attracting increasing attention. In recent years, beyond traditional visual paradigm, Vision-Language Model (VLM) has been extensively explored to boost this field. However, in currently-existing VLM-based FSAD schemes, almost all perform anomaly inference only by pairwise feature matching, ignoring structural dependencies and global consistency. To further redound to FSAD via VLM, we propose a Heterogeneous Hypergraph Vision-Language Reasoning (H2VLR) framework. It reformulates the FSAD as a high-order inference problem of visual-semantic relations, by jointly modeling visual regions and semantic concepts in a unified hypergraph. Experimental comparisons verify the effectiveness and advantages of H2VLR. It could often achieve state-of-the-art (SOTA) performance on representative industrial and medical benchmarks. Our code will be released upon acceptance.