· AIM: This study was conducted to compare the outcomes of amniotic membrane transplantation (AMT) with conjunctival autograft transplantation (CAT) in primary and recurrent pterygium. The main outcome measurement was the recurrence rate after surgery.· METHODS: This study was designed as a prospective study on consecutive cases of pterygium from April 2004 to Feb2006. The cases were randomly divided into two groups of AMT (26 cases) and CAT (24 cases). All subjects were operated with an extensive excision of the fibro vascular tissues with AMT or CAT approach. Patients were followed for recurrence and complications for 24 months. The surgical procedures were performed by a single surgeon.The associations between demographic variables, surgical techniques (AMT, CAT), recurrences and postoperative complications were analyzed.· RESULTS: The patients' male to female ratio was 4:1. Involvement of right to left eye ratio was 3:2. Pterygium in70% of cases was primary and in 30% was recurrent. The most common clinical signs were red eye and reduced visual acuity while the most common complications were recurrence and corneal scar. In the first month of follow up, the recurrence rates in AMT and CAT approaches were 3.8% vs 8.3%respectively and these rates increased to 46.2% vs 25% respectively after 24 months of follow up.· CONCLUSION: The success rate of 2 years follow up was better in CAT technique. The AMT technique for pterygium surgery has an unacceptably high recurrence rate.