OBJECTIVE To evaluate the success rate of topical cyclosporine A (tCsA) (Restasis, Allergan) in preventing the recurrence of pterygium excision and conjunctival flap rotation technique in patients applying to our clinic and diagnosed with pterygium. METHODS A total of 56 eyes with primary pterygium in 56 patients were examined and operated with pterygium excision and conjunctival flap rotation technique between October 2008 and September 2009. A total of 26 eyes of these 56 patients were treated with tCsA (Restasis, Allergan) for 6 months during the postoperative period and assigned as the treatment group. The other 30 eyes of 56 patients were assigned as the control group. The operated patients were followed up for approximately 11 months. RESULTS The 2 groups were similar in age, sex, and pterygial size. The largest percentage of the patients were farmers (30.3%). The pterygium recurred in 8 (14.2%) of 56 patients; 2 of them were in the treatment group (7.7%) and 6 of them were in the control group (20.0%). There was not any complication threatening vision among operated patients. Recurrence rates between the control and treatment group were statistically significant (p<0.05). The complication and postoperative compliance rates were lower in the treatment group than the control group. The difference between preoperative and postoperative Schirmer I test results among the treatment and control group was statistically significant (p<0.05). The Schirmer I test results increased after tCsA treatment for patients assigned to the treatment group. CONCLUSIONS The results suggest that tCsA (Restasis, Allergan) can be used safely and effectively after pterygium surgery to obtain lower rates of recurrence.