To evaluate the safety and efficacy of intraoperative subconjunctival bevacizumab as an adjunctive treatment after surgical excision of primary pterygium. This was a randomized prospective clinical study. Group 1 (21 eyes) underwent pterygium excision with conjunctivo-limbal autograft. Group 2 (20 eyes) received subconjunctival 1.25 mg/0.05 mL of bevacizumab at the end of the surgery. There were no statistically significant differences regarding age, sex, laterality, or dimensions of the pterygia or grafts between the two groups (P > .05, 95% confidence interval). After 8 months of follow-up, two eyes in group 1 and four eyes in group 2 had recurrent pterygia. One patient in group 2 had lost graft. The difference in recurrence rate between the two groups did not reach statistical significance (P = 0.4, 95% confidence interval). Intraoperative subconjunctival bevacizumab following primary pterygium surgical excision is not helpful and possibly harmful. Larger studies are needed.