The surgical technique and postoperative problem management of conjunctival autograft transplantation for advanced primary and recurrent pterygium are reviewed. Problems such as graft edema, corneoscleral dellen, and epithelial inclusion cysts infrequently occur. Corneal astigmatism, Tenon's granuloma, retraction and/or necrosis of the graft, and muscular disinsertion are even less frequently encountered. Limbal-conjunctival autograft for recalcitrant recurrent cases is proposed.