This is the first report of a randomized trial of the conjunctival autografting technique for pterygium removal. This trial was conducted in the Caribbean where risk of pterygium recurrence is considered to be high. Although not statistically significant, there was a lower recurrence rate in grafted cases (21% of 19 cases) than in controls done by the bare sclera technique (37% of 16 cases). The author found that age of the patient was strongly associated with recurrence regardless of which procedure was used. Findings of this study emphasize the importance of randomized controlled trials in assessing the efficacy of specific procedures for pterygium removal.