To assess the rate of recurrence, complications, and cosmesis after recurrent pterygium removal with P.E.R.F.E.C.T. for PTERYGIUM (Pterygium Extended Removal Followed by Extended Conjunctival Transplant). A case series study of P.E.R.F.E.C.T. for PTERYGIUM was conducted by 1 surgeon with a 1-year follow-up to assess the recurrence, complication rate, and cosmesis. A total of 111 consecutive patients with recurrent pterygium removals. A major modification of conjunctival autograft surgery was used to treat recurrent pterygia. The recurrence rate, complications, and cosmesis after excision of recurrent pterygia using P.E.R.F.E.C.T. for PTERYGIUM. There were no patients with recurrence in 111 consecutive patients, and all but 2 patients were followed for at least 1 year. One patient developed an exotropia that required no treatment, and 1 patient lost 4 lines of vision as a result of a corneal ulcer. In this series, P.E.R.F.E.C.T. for PTERYGIUM resulted in a zero recurrence rate (2 patients lost to follow-up) with few complications and a good cosmetic appearance.