Objective To investigate the effect of limbal stem cell autologous transplantation on the stability of tear film after pterygium excision. Methods 119 patients with pterygium treated in our hospital from June 2022 to June 2023 were selected and divided into control group (pterygium excision, n=59) and observation group (pterygium excision combined with autologous limbal stem cell transplantation, n=60) by random number table method. The functional stability of tear film, tear film stability, corneal refractive status, complications, visual acuity and recurrence rate were compared between the two groups after treatment. Results At 1 and 2 months after treatment, the SIT value and tear film rupture time in observation group were higher than those in control group (P<0.05). After treatment, the proportion of tear film function grade Ⅰ to Ⅱ, UCVA, horizontal curvature of cornea and vertical curvature of cornea in observation group were higher than those in control group (P<0.05). The rate of complications and recurrence within 6 months in the observation group was lower than that in the control group (P<0.05). Conclusion Pterygium resection combined with autologous limbal stem cell transplantation can further improve tear film stability and corneal refractive status, with low recurrence rate and high safety.