To study the safety and efficacy of pterygium extended removal followed by extended conjunctival transplant for recurrent pterygia. Thirty-three eyes of 33 subjects with recurrent pterygia were enrolled in this prospective case series study. Pterygium extended removal followed by extended conjunctival transplantation was performed in all subjects. One surgeon (WA) performed all surgeries. All subjects completed follow-up for at least 12months and were evaluated for recurrence and complications. The mean age of the participants was 41.2 ± 10.3years (range 22-60), 7 females (21.2%). The mean duration of follow-up was 25.64 ± 9.24months (range 12-43). Corrected distance visual acuity (decimal notation) improved from 0.69 ± 0.22 (range 0.2-1.0) at presentation to a 1-year postoperative value of 0.83 ± 0.2 (range 0.3-1.0). No recurrence was reported in all subjects throughout the follow-up period. Transient graft swelling was recorded in 14 cases (42.4%) and resolved in all cases by the first week. All patients developed variable degrees of transient postoperative diplopia that resolved completely by the first 6weeks. Donor site granuloma developed in 4 cases (12.1%). Spontaneous resolution was observed in 3 cases, while in one case, surgical excision was performed 2months after the procedure. In this study of eyes with recurrent pterygia, pterygium extended removal followed by extended conjunctival transplant was found safe and effective with no recurrence and minimal postoperative complications.