Purpose:  To find out the efficacy and structural stability of autologous serum for the fixation of limbal conjunctival Autograft in the management of pterygium surgery. Study Design:  Quasi-experimental study. Place and Duration of Study:  Orbit and Oculoplastic department of LRBT Hospital, Karachi, from June 2020 to November 2020. Methods:  This study included 100 eyes of 100 patients with primary pterygium.Eyes with nasal Pterygium of grade III were included. Patients with ocular surface disorders, infection, inflammation, pseudo pterygium, pterygium at temporal side and coagulation disorders were excluded. After pterygium excision, a free limbal conjunctival Autograft was taken from superotemporal quadrant of bulbar conjunctiva of same eye and was used to cover the bare sclera with autologous serum. Subconjunctival injection of antibiotic and steroid was given followed by 24 hour of eye pad. Postoperative outcomes of the graft were noted at theend of the six months period of follow up. Results:  The mean age of the patients was 46.5 ± 8.97 years (range 20 – 60 years). Male to female ratio was 3:1 (75 males and 25 females). Graft loss was found in five patients, graft edema in one patient, graft retraction in three patients, graft overriding in two patients, recurrence of pterygium in six patients, granuloma in two patients and subconjunctival hemorrhage in 10 patients. Conclusion:  Autologous serum for fixation of limbal conjunctival Autograft is a safe, efficient and cost-effective method of treatment for primary pterygium surgery.