OBJECTIVE To evaluate the efficacy of surgical management of pterygium with corneo-conjunctival autograft transplantation. METHODS Ophthalmology Department, Bicêtre Hospital, University Paris XI and the Assistance Publique Hôpitaux de Paris, France. METHODS The records of 104 patients (114 eyes), comprising 40 women and 64 men, who underwent corneo-conjunctival autograft transplantation for primary (104 eyes) and recurrent (10 eyes) pterygia between 1992 and 1998, were reviewed in a retrospective survey. Follow-up ranged from 12 to 78 months (mean 22.5 months). RESULTS All grafts were planted promptly and donor sites re-epithelialized with no excessive scar tissue formation. No recurrence was noted. Improvement of visual acuity was achieved in 24 patients and stabilization was achieved in 76 patients. The main complication was progression of corneal astigmatism exceeding 4 dioptres in two patients. CONCLUSIONS These results indicate that corneo-conjunctival autograft transplantation is an effective treatment for pterygia.