AIM:To study the effect of pterygium excision under microscope combined with free autologous bulbarconjunctiva flap transplantation. METHODS:Totally 93 cases (97 eyes) of pterygium underwent pterygium excision combined with free inferior autologous bulbar conjunctiva graft surgery. The postoperative recovery was observed. RESULTS:Patients were followed up for 6 to 18 months.There were 3 eyes of recurrences (3%), 1 eye of concurrent inflammatory polyp (1%), and no other complications. CONCLUSION:Pterygium excision under microscope combined with autologous free bulbar conjunctiva graft for pterygium surgery is an effective method, with the advantages of lower recurrence rate and without affecting cataract and glaucoma surgical incision.