A significant degree of corneal astigmatism can be induced by the encroachment of a pterygium onto a cornea. The pterygium generally causes with-the-rule corneal astigmatism that is hemimeridional on the side of the pterygium. There is a significant correlation between the extension of the pterygium onto the cornea and the amount of induced astigmatism. However, there is a poor correlation between pterygium-induced astigmatism measured topographically and that measured by manifest refraction. Successful pterygium surgery will reduce pterygium-induced refractive astigmatism and improve visual acuity. This paper outlines the management of a patient with an advanced pterygium, in whom a large degree of corneal astigmatism was induced by the encroachment of a pterygium onto the cornea. Subsequent excision of the pterygium brought about a reversal of the pterygium-induced corneal astigmatism.