Purpose: To evaluate the safety and effectiveness of conjunctival rotation autograft technique in preventing the recurrence of primary pterygium. Methods: In this prospective study, 24 eyes of 24 consecutive patients with primary pterygium were evaluated. Conjunctival rotation autograft technique, which involved the removal of the underlying fibrovascular pterygium tissue and replacement of the original epithelium over the bare sclera with a 180degrees rotation was performed in all eyes. Results: Patients were 34-70 years of age (mean, 52.8; SD = 10.5). During the mean follow-up of 15.9 months (range, 12-23 months; SD: 4.0), 4 recurrences (16.6%) were observed. Neither intraoperative nor postoperative complications were encountered except for recurrences and 3 suture openings, which were re-sutured postoperatively without further complications. Conclusion: Conjunctival rotation autograft technique appears to be effective and safe in preventing the recurrence of primary pterygium. A prospective randomised trial comparing conjunctival rotation autografting with other adjunctive procedures in addition to simple pterygium excision is required to determine its effectiveness. Copyright (C) 2002 S. Karger AG, Basel.