PURPOSE. To evaluate the effectiveness of autologous labial salivary gland with labial mucous membrane graft in a rhesus monkey model with severe dry eye. METHODS. Eight eyes of eight rhesus monkeys with severe dry eye were included. Four eyes underwent autologous labial salivary gland and mucous membrane graft (group 1) and four eyes served as controls (group 2). The ocular surface was evaluated before and after transplantation surgery (at 1, 4, 8, 12, and 24 weeks). Conjunctival impression cytology was performed before and 24 weeks after transplantation. Finally, a histological analysis of the cornea, conjunctiva, and transplanted grafts was performed. RESULTS. At inclusion (n = 8) the mean Schirmer test was 1.31 +/- 0.53 mm, the mean fluorescein score was 4.7 +/- 1.65, and the mean lissamine green staining was 4.38 +/- 0.48. After transplantation, a significant increase in tear secretion was observed with the mean Schirmer test results in group 2 significantly higher than those observed for group 1 at all time points (P < 0.05). Similarly, fluorescein and lissamine green scores were significantly lower in group 2 than in group 1 at all time points after transplantation (P < 0.05). Impression cytology specimens showed severe conjunctival squamous metaplasia without goblet cells in both groups. Under light microscopy, no significant difference was observed between the cornea and the conjunctiva of the two groups. CONCLUSIONS. Labial salivary gland transplantation provided a basal secretion of tears and improved ocular surface staining scores during the first 3 months in a severe rhesus monkey model of dry eye. However, this was not accompanied by major improvement of ocular surface tissues.