Aim: The aim of this study is to compare the outcome of conjunctival autograft (CAG) surgery for pterygium using autologous serum versus fibrin glue. Materials and Methods: A prospective, randomized controlled trial was carried out on 40 patients over a period of 2 years. Group I (20 eyes) underwent CAG with fibrin glue and Group II (20 eyes) underwent CAG with autologous serum. Postoperatively, the parameters noted in both the groups were the time taken for surgery in both the groups, postoperative outcomes such as redness and discomfort during blinking, outcome of the graft (graft edema, graft retraction, graft rejection, graft displacement, and graft loss), and recurrence of the pterygium. Results: In Group I (autologous serum), the mean surgical time was 34.8 min (standard deviation [SD] = 3.664912), whereas in Group II (fibrin glue), the mean surgical time was 22.95 min (SD = 3.086047). The intensity of postoperative discomfort was greater in Group I (autologous serum) than Group II (fibrin glue) on postoperative visits. However, the difference was not statistically significant. Graft rejection was observed in one patient belonging to the fibrin glue group, after 1 month postoperatively, which eventually by the end of 3 months led to graft loss. We found decreased postoperative inflammation and decreased recurrence rate at both a 3- and 6-month time period with the use of fibrin glue compared with autologous serum. Conclusion: Fibrin glue is generally considered safe; however, since it is made from human plasma, it carries the risk of transmitting infections. There was marked reduction in the operating time in fibrin glue group as compared with the autologous blood group. Cost of the surgery was more with fibrin glue. The graft edema, graft loss, graft retraction, and displacement of the graft were more with the use of fibrin glue. However, the difference was not statistically significant.