Objective To analyze the effect of limbal stem cell transplantation combined with pterygium excision on ocular function recovery in patients with pterygium. Methods A total of 81 patients with pterygium admitted to Guangyang District Ophthalmology Hospital from January 2024 to February 2025 were selected, and they were divided into the control group (n =40) and the observation group (n =41) by the random number table method. The control group underwent pterygium excision, and the observation group underwent limbal stem cell transplantation on the basis of the control group. The ocular function recovery, ocular appearance aesthetic effect, complication rate and corneal astigmatism degree were compared between the two groups. Results The ocular function recovery of the observation group was better than that of the control group (P <0.05). The scores of pterygium residue, conjunctival flatness, corneal transparency and total aesthetic score in the observation group were lower than those in the control group (P <0.05). The incidence of complications in the observation group (9.76%) was lower than that in the control group (55.00%) (P <0.05). The corneal astigmatism degree of the observation group after treatment was lower than that of the control group (P <0.05). Conclusion In the treatment of pterygium, the combined application of pterygium excision and limbal stem cell transplantation can optimize ocular function recovery and appearance aesthetic effect, and effectively reduce the incidence of postoperative complications and corneal astigmatism degree, showing better comprehensive curative effect.