High-dimensional vector similarity search (HVSS) is receiving a spotlight as a powerful tool for various data science and AI applications. As vector data grows larger, in-memory indexes become extremely expensive because they necessitate substantial expansion of main memory resources. One possible solution is to use disk-based implementation, which stores and searches vector data in high-performance devices like NVMe SSDs. However, HVSS for data segment is still challenging in vector databases, where one machine has multiple segments for system features (like scaling) purpose. In this setting, each segment has limited memory and disk space, so HVSS on data segment needs to balance accuracy, efficiency, and space cost. Existing disk-based methods are sub-optimal because they do not consider all these requirements together. In this paper, we present Starling, an I/O-efficient disk-resident graph index framework that optimizes data layout and search strategy in the segment. It has two main components (1) a data layout that includes an in-memory navigation graph and a reordered disk-based graph with locality enhancement, which reduces the search path length and disk bandwidth wastage; and (2) a block search strategy that minimizes expensive disk I/Os when executing a vector query. We conduct extensive experiments to verify Starling’s effectiveness, efficiency, and scalability. On a data segment with 2GB memory and 10GB disk capacity, Starling can maintain up to 33 million vectors in 128 dimensions, and serve HVSS with more than 0.9 average precision and top-10 recall rate, and latency of under 1 millisecond. The results show that Starling exhibits 43.9x higher throughput with 98% lower query latency than state-of-the-art methods under the same accuracy.