OBJECTIVE: To determine changes in tear film characteristics and dry eye symptoms in patients who underwent primary pterygium excision with conjunctival autograft. METHODS: A prospective, descriptive, analytic study was performed. Patients with primary pterygium who underwent surgical excision with conjunctival autograft were included. Ocular surface disease index (OSDI) test, noninvasive break-up time (NIBUT), lipid layer interferometry, tear meniscus height, and meibomian gland dropout were evaluated preoperatively and at 1 week, 1 month, and 3 months postoperatively. RESULTS: Thirty-three eyes of 31 patients were included, 16 were right eyes, 20 patients were female, and with the average age of 51±9 years. The tear film and dry eye symptom findings before surgery were as follows: OSDI test 36.34±22.04, NIBUT 8.30±1.17 sec, interferometry 53.03±32.32 nm, tear meniscus height 29.90±10.01 mm, superior meibomian gland dropout 24.78%±9.86%, and inferior meibomian gland dropout 22.57%±14.62%. There was a significant decrease in the postop OSDI score to 23.12, as well as tear meniscus height to 24.36 at 3 months postop, and significant improvement in superior (21.03%) and inferior (15.06%) meibomian gland dropout in the final visit. CONCLUSION: Primary pterygium excision with conjunctival autograft seems to help improve dry eye-related symptoms and tear film characteristics, with a statistically significant change in postop OSDI scores, tear meniscus height, and meibomian gland dropout. Changes in other objective evaluations of tear film characteristics were not as evident.