OBJECTIVE: To compare the effectiveness of the adjunctive mitomycin C and bevacizumab in preventing pterygium recurrence after surgery at St. Joseph’s Eye Hospital Mgbirichi, Imo State. MATERIALS AND METHODS: Consecutive adult patients with primary pterygium were identified at the outpatient clinic and randomly assigned to receive either intra-operative subconjunctival bevacizumab of 2.5mg/0.1ml or application of 0.2mg/ml (0.02%) of mitomycin C for 5 minutes after pterygium excision. Post-operatively, the patients were followed up for 6 months. The main outcome measure was recurrence rate. Post-operative complications were secondary outcomes. RESULTS: Of the 90 patients studied, 45 received subconjunctival bevacizumab and another 45 received application of mitomycin C. There were 51 (56.7%) females and 39 (43.3%) males. The age range was 30-70 years; mean age 55.4 ± 4.0 years. The 50 – 59 years accounted for 33 (36.7%) while in the 30 – 39 years were 6 (6.7%). Urban dwellers constituted 58 (64.4%) while outdoor workers were 69 (76.7%). Common ocular complaints were foreign body sensation 72 (80%), redness 69 (76.7%), burning sensation 63 (70%), itching 63 (70%), and blurring of vision 44 (48.9%). While grade 2 pterygium accounted for 46 (51.1%), grade 1 pterygium was least 7 (7.8%). Postoperatively, the complications seen at 6 – 24 weeks were persistent redness 17 (18.9%), and granuloma 2 (2.2%). Bevacizumab group had a higher recurrence rate with 11 (24.4%) patients, compared to 2 (4.4%) patients in the mitomycin C group (P= <0.001). All the 13 patients with recurrence had fleshy pterygium.