A rationale for the management of pterygium, based on theory and clinical experience, is presented in this review. Pterygium is classified as primary, secondary (recurrent), or pseudopterygium. Empirical data and proposed theories of pterygium pathogenesis and recurrence are discussed. The treatment of pterygium based on this information is divided into four phases: diagnosis, medical therapy, surgery, and postoperative adjunctive measures. The indications, techniques, results, and complications of the postoperative adjunctive measures used to lower recurrence are considered. Guidelines for the treatment of pterygium are recommended.