ABSTRACT Background: pterygium is a common disease that affect many people in the world especially in the tropics and in an equatorial zone between 30° north and south latitudes. Egypt is one of the highly affected contraries. The most important problem in treatment of pterygium is high recurrence rate. Aim: to compare conjunctival autograft and intraoperative mitomycin C to determine the best technique that can reduce the recurrence rate. Methodology: this prospective interventional study comprised 40 eyes of 40 patients with primary pterygium included from the outpatient clinics of the ophthalmology departments at Al-Zahraa University Hospital and The Italian Military Hospital over a period of 15 months (from March 2019 to May 2020). They were randomized into two groups according to the adjuvant used: (1) intraoperative 0.02% MMC for 3 minutes or (2) conjunctival autografting technique. Patients were followed for recurrence and complications for a period of 6 months. Results: 40 eyes of 40 patients their age ranged from 21 and 65 years in group (1) and between 27 and 60 years in group (2) with a male predominance of 30 cases (75%). There were 2 recurrences (10%) in MMC group and 1 recurrence (5%) in conjunctival autograft group. There was no statistically significant difference in the recurrence rate between the two groups. There were 2 cases of granuloma one case in each group and one case of partial graft dehiscence in group 2. Conclusion: Both conjunctival autograft and intraoperative mitomycin C techniques are effective treatment modalities for treatment of primary pterygium and for reduction of recurrence rate. There is no significant difference between both techniques as regards the recurrence rate.