Introduction: Gender equality has been a priority area of demographic research. One of the major reasons for high fertility and low acceptance of family planning is the prevalence of gender preference among couples. The objectives of this study were to identify the determinants and examine the extent of gender preference on fertility.

Methods: This is a cross-sectional study carried from June 2008 to July 2009 in Duhavi VDC of Sunsari district of Nepal. Three hundred and ? ve randomly selected ever-married women of 15 - 49 years, who had at least one child were the subjects of the study. A questionnaire covering the areas on gender and fertility preference and methods and use of contraception was given and ? lled up.

Results: The study showed that 42.6 % of the ever-married women belonged to the 25 - 29 years age group. Around 92 % of women whose last child was a male were using family planning methods whereas only 40 % of women whose last child was a female were using family planning methods. This difference was statistically signi? cant (P < 0.0001).

Conclusions: The contraception use among the women having a female child was low, showing a desire for a male child which is one of the factors in the increase of family size in our society. Due to the patrilineal society, women are discouraged in the practice of contraception. Effective intervention programs need to be planned and conducted to rectify this situation.