Aims: To evaluate the visual, refractive, and topographic outcomes after primary nasal pterygium excision with conjunctival autograft. Patients and Methods: The study included a total of 60 eyes of 60 patients with primary nasal pterygium. Visual and refractive in addition to topographic par-ameters (UDVA, CDVA, spherical equivalent, simulated keratometry "Sim K-1, Sim K-2, K-max, K-mean", CYL and Pachymetry) were evaluated preoperative and 3 months postoperative. Also, postoperative complications and recurrence rates were determined. Results: Postoperative UDVA and CDVA significantly improved (p < 0.01 and p=0.03 respectively). Sphere, cylinder, and posto-perative SE were changed significantly. Pterygium excision with conjunctival Autograft has an obvious effect in increasing K-1 (p < 0.01), and decreasing K-2 (p=0.04) with a subsequent decrease in K-max (p=0.02) and increase in K-mean (p < 0.01). The postoperative corneal pachymetry was not affected significantly (p=0.18). Recurrence was recorded in 2 cases (3.3%). Conclusion: The visual, refractive, and corneal topographic changes caused by pterygium improved significantly after successful pterygium surgery which decreases topographic astigmatism and reverses corneal flattening caused by pterygium. The conjunctival autograft technique is efficient and safe for pterygium excision. Further studies with longer follow-up periods are warranted to evaluate the long-term outcomes, particularly the recurrence rate.