Objective: To compare and evaluate the efficacy of conjunctival autograft with mitomycin C and without mitomycin C (MMC) techniques as two treatment options for primary pterygium.Material and Methods: Retrospective comparative study carried in 60 patients included 60 eyes with primary pterygium. 30 eyes of 30 patients (group A) underwent pterygium excision followed by conjunctival autograft. 30 eyes of 30 patients (group B) underwent pterygium removal followed by intra operative application of 0.02% MMC for 2 minutes with conjunctival preservation. Both groups were compared in terms of surgery time, pterygium size, cosmetic effect, pterygium recurrence and complications. Results: Mean pterygium size was (3.5 ± 0.50 mm and 3.2 ± 0.74 mm) in group A and B, respectively (p =0.1). Mean surgery time was significantly shorter in MMC group (20.40± 5.00 min) as compared to conjunctival autograft group (28.00 ± 7.0 min) (p < 0.001). Pterygium recurrence was not seen in any of the patient. Mean follow up time was (6 ± 3 and 6 ± 2 months) in group A and B, respectively (p = 0.4).Conclusion: Both conjunctival graft with and without MMC techniques are comparable as regard of pterygium recurrence. MMC technique has significantly shorter surgery time, better cosmoses and lower incidence of complications. Preserving the conjunctiva should be considered when the patient has a history of glaucoma or there is insufficient conjunctiva.