AIM:To estimate the influence of pterygium excision with autologous conjunctiva-flap transplantation upon tear film function in patients with pterygium. METHODS: All patients undergoing pterygium excision with autologous conjunctiva-flap transplantation received the tear film break-up time (BUT), Schirmer I test and tear fern test (TFT) at preoperative 1 day and postoperative 3,7,30 days,conjunctival impression cytology (CIC) of tear film mucous layer was tested at 1 day before surgery and 30 days after surgery to evaluate the function of tear film. RESULTS: A total of 87 cases (87 eyes) enrolling in the current study, 45 cases were male, 42 cases were female. Patientsage ranged from 45 to 81 years with an average age of 64.1±8.8 years. Mean BUT at 30 days of follow-up was longer than that before surgery, they were 11.47±323 seconds and 9.43±3.25 seconds, respectively (P<0.05). The proportion of cases with normal results of TFT (graded as TypeⅠandⅡ)was 90% which was significant higher than that tested before surgery (P<0.05). Goblet cell density after surgery (39.73±18.46/10 high power microscopic) was higher than preoperative results (48.85±18.80/10 high power microscopic) with a significant difference(P<0.05). Improvement of Schirmer I test was found between first test and early tests after surgery (P<0.05), whereas it wasnt observed between the first and the last test (P>0.05). CONCLUSION:Pterygium excision with autologous conjunctiva-flap transplantation can improve the function of tear film.