This article examines the shifts in conceptions and behaviors pertaining to patterns of sex preferences among families living in HCMC, Vietnam. It utilizes survey methods, including questionnaires and in-depth interviews, with a sample size of 657 cases. The study’s findings reveal that, although couples still desire a balanced mix of sons and daughters, parents, particularly mothers, exhibit a more egalitarian perspective on the sex of their children compared to previous generations. Couples now perceive the sex of their forthcoming child as equally significant and prioritize the emotional value of their children over the economic worth. Notably, the gender of the last child and the mother’s level of educational emerged as significant in determining child sex preferences. Mothers with a college degree or higher tend to hold more equal views regarding the sexes of their children, regardless of whether they are sons, daughters, or exclusively daughters.