Objectives: To find the Child Sex Ratio (CSR) in the urban slum and elite area of Nagpur and also to compare child sex ratio according to birth order and sex of previous born child. Methods: Study involved house to house interview of mothers of 0-6 year children from urban slum and elite area of Nagpur. Information regarding all children born in last 6 years, their date of birth, birth order, sex and information regarding any abortions was noted. . Results: CSR was 934 females per 1000 males combined for both areas. CSR was significantly low (P<0.05) in elite area (904 females per 1000 males) compared to slum area (964 females per 1000 males). In elite area, when first-born child was female, in second birth order number of males was significantly higher than females (P<0.05). There was significant difference between number of males and females of second birth order, when first-born child was male compared to when it was female (P<0.001). Conclusion: There is missing of girl child form the second and subsequent birth order, especially when the previous born child is female, which is more evident in elite area.