AIM:To analyze the clinical manifestations, causes and treatment of scleral complications after different pterygium surgery. METHODS:By retrospective study, the 577 cases (857 eyes) with primary pterygium were divided into 4 groups according to different surgical procedures. The clinical manifestations, causes and treatment were observed. RESULTS:A total of 39 eyes appeared different degree scleral complications. There were more stimulating symptoms and scleral complications in the group Ⅱof pterygium resection combined with mitomycin than those in other groups (P<0.01), followed by group Ⅰof pterygium resection. 34 eyes were cured after eyedrops of hydroxymethyl propyl and Basic Fibroblast Growth Factor(BFGF) in about 2 weeks. 5 eyes with scleral necrosis were gradually healing after the debridement and fresh amniotic membrane transplantation. CONCLUSION:Early detection and effective treatment, preoperative prevention are very important in the scleral complications,correct pterygium surgery and eyedrops can effectively reduce scleral complications.