Objective: To use anterior segment optical coherence tomography (AS-OCT) for structural imaging and accurate measurements of pinguecula and pterygium in order to understand the structural features of these lesions. Methods: This study was a prospective parallel control study. Lateral bulbar conjunctiva of 25 cases (30 eyes) that included pinguecula (10 eyes of 8 cases), pterygium (10 eyes of 9 cases), and normal eyes (10 eyes of 8 cases), were enrolled from the Department of Ophthalmology of the Fourth Affiliated Hospital of Zhejiang Medical University from January to April 2018. The anterior segment module of an Optovue optical coherence tomography angiography (OCTA) was used for measurements. The thickness of the bulbar conjunctiva epithelium and propria tissues at sites at a distance of 0.0 mm, 0.5 mm, 1.0 mm,1.5 mm, 2.0 mm and 2.5 mm from the scleral process were stratified within the 2.5 mm range, were measured, compared and further analyzed. The data were described by means of mean ± standard deviation.Repeated measurement analysis of variance was used for comparison of each point in the group, one-way analysis of variance was used for comparison between groups. results: Compared with normal eyes and pinguecula eyes, pterygium showed thickened epithelium in 0.5 mm point (P<0.05). In the 2.5 mm range on the nasal side, pterygium and pinguecula showed thickened subepithelium tissues (P<0.05), especially for pterygium, compared to normal eye tissue. conclusions: AS-OCT can image microstructures in benign conjunctival proliferative diseases, resulting in accurate quantitative diagnosis and evaluation. The thickness of subepithelium tissues increases in pinguecula and pterygium.