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Background: Pterygium is a degenerative ocular surface disorder strongly influenced by ultraviolet exposure, environmental irritants, and limbal stem cell dysfunction. Dry eye disease (DED) is a complex condition that causes tear-film instability and has been linked to pterygium development. Aim: This study was designed to investigate and compare the association between pterygium and dry eye. Methods: A total of 158 patients with clinically diagnosed pterygium were enrolled. Demographic, occupational, and environmental data were collected. Dry eye was assessed using Schirmer’s test and tear film break-up time (TBUT). Statistical analysis was conducted using SPSS, employing Fisher's exact test or t-test to assess the relationships. Results: Of the 158 participants, 56.7% were women. The average age was 47.2 years, with a standard deviation of 12.2 years. Most participants lived in rural areas (70.9%) and were either unemployed (34.8%) or farmers (31.6%). The most common symptoms were a foreign-body sensation, blurred vision, cosmetic intolerance, and a gritty sensation. Dry eye was present in 60.8% of patients, with prevalence increasing significantly with age (p < 0.05). No significant differences were observed by sex or affected eye. Schirmer’s test values were much lower in patients with dry eye (9.95 ± 3.58 mm) than in those without dry eye (22.98 ± 5.49 mm; p < 0.001). TBUT was also significantly shorter in dry eye cases (6.45 ± 2.99 seconds) compared to controls (15.27 ± 3.93 seconds; p < 0.001). Conclusion: This study highlights a strong association between pterygium and dry eye disease, influenced by age, occupation, and environmental exposure. Tear film dysfunction is central to disease development, underscoring the need for routine dry eye screening and preventive measures, especially in rural and outdoor‑working populations. Longitudinal studies are needed to assess postoperative outcomes and recurrence, clarifying the long-term impact of dry eye on pterygium progression. Key words: Pterygium, Dry eye, Schirmer’s test, Tear film break-up time, North East India