Objective To determine whether intraoperative mitomycin C （MMC） can enhance the efficacy of limbal conjunctival autograft transplantation（LCAT） for the treatment of primary and recurrent pterygium. Methods This was a prospective case-control study. One hundred and thirty-four eyes of 114 patients with primary and recurrent pterygium were randomly divided into 2 groups. In group A， 63 eyes with primary pterygium and 7 eyes with recurrent pterygium were treated with pterygium resection and LCAT combined with a local application of MMC. In group B， 57 eyes with primary pterygium and 7 eyes with recurrent pterygium underwent pterygium resection and limbal conjunctival autograft transplantation alone. Epithelial regeneration， rate of pterygium recurrence， visual prognosis and complications were evaluated and compared between the two groups. The mean follow-up was 23.3±8.6 months with a range from 12 to 65 months. Data were analyzed using an independent t test and chi-square test. Results No intraoperative complications were found in any eyes. Postoperative corneal epithelial regeneration took an average of 4.0±0.8 days and 3.4±0.6 days in groups A and B， respectively （t=-3.71， P>0.05）. The rate of pterygium recurrence was 3% in both groups （χ²=0.008， P>0.05）. Postoperative visual acuity improved or remained stable in 74% of group A and 65% of group B （χ²=1.301， P>0.05）. Postoperative complications included delayed corneal epithelial recovery， limbal conjunctival autograft lag， corneal dellen， and subepithelial inclusion cyst in group A （6%） and group B （5%） （χ²=0.071， P>0.05）. Conclusion Intraoperative use of MMC does not enhance the efficacy of LCAT for the treatment of pterygium and may lead to a delay in corneal epithelial recovery.