Aim: To determine gender ratio in the local population at a tertiary maternity care center in Southern India. Objective: To identify the sex ratio. To determine the sex ratio among preterm deliveries as well as among anomalous babies at a local tertiary care center in India. Materials and methods: Retrospective study done for a period of 84 months between January 1, 2009 and December 31, 2015 at Lady Goschen Hospital, Mangaluru, Karnataka, India. Results: There are 39746 births during the study period. Total number of live births were 38,737. The total number of still births & IUD were 1009. The number of anomalous fetus delivered were 262. The number of preterm deliveries were 4095. Gender ratio among total births was 102.07. Gender ratio in anomalous fetus was 110.92. Gender ratio in preterm fetus was 89.65. Conclusion: The gender of the unborn baby also seems to play a role in the process of being born anomalous or prematurely. The higher incidence of female babies being born preterm and anomalous could be responsible for the skewed gender ratio.