AbstractPurposeTo describe the complications of conjunctival graft surgery occurring in cases at a referral ophthalmic service and evaluate factors that lead to occurrence of complications in canine cases.MethodsA retrospective case–control study was completed using data from the Veterinary Medical Center at the Western College of Veterinary Medicine, Saskatoon, Canada, between May 2015 and March 2020. Case records from dogs that underwent conjunctival pedicle graft surgery and subsequently either did or did not develop a conjunctival graft complication were reviewed.ResultsOne hundred and six dogs undergoing conjunctival graft surgeries were identified. Sixteen conjunctival graft complications occurred, of which, eight led to negative outcomes. Univariable analysis comparing canine eyes that developed complications to control eyes revealed potential (p ≤ .05) differences between the groups in post‐operative fluoroquinolone use,Streptococcus canisisolation, intraoperative intravenous cefazolin use, corneal stromal white cell infiltrate, and mean ulcer diameter. The use of intraoperative cefazolin could not be effectively evaluated with available data; however, no dogs (n = 22) receiving intraoperative cefazolin developed complications. Multivariable analysis revealed that dogs that were treated with a second‐generation fluoroquinolone and that hadS. canisisolated had higher odds of experiencing complications than dogs that were not treated with a second‐generation fluoroquinolone and that wereS. canisnegative (Odds ratio = 64.7 [95% CI 6.3–669],p < .0001).ConclusionsStreptococcusspecies played a role in conjunctival graft complications in our study. Empiric selection of second‐generation fluoroquinolone monotherapy may need reconsideration given the frequent isolation ofStreptococcusspp. from canine ulcers. The use of intraoperative cefazolin may be associated with a lower complication rate.