Objectives: To determine fertility preferences with reasons among Pakistani women of reproductive age. Methods: A questionnaire based survey was conducted among 200 married women coming to OBGYN department of Liaquat university hospital Hyderabad, Sindh during the period of September to December 2009. The administered questionnaire served to find the demographic characteristics of women, desired family size and reason for this preference. Ethical consideration and confidentiality was ensured. The data entry, processing and analysis were done using SPSS soft ware No.15 Sample Size: 200 women of reproductive age Results: The mean age of the sample was 29.65±4.92 years. No formal education was attained by 87(43.5%) women and, monthly income less than 10000 was seen in 153(76.5%) with 141 (70.5%) women living in joint family units. One hundred and fourteen (57%) women belonged urban areas of Hyderabad.(Table I) When questioned about desired family size 79(39.5%) responded they want 4 children and only36 (18%) wanted 2. On asking reason for particular size of the family 84(42%) women answered they just like it that way with out any reason.Table II Conclusion: Nearly 60% (39.5% want4 children and 21.5%more than 4) of women prefer 4 children in their homes. And 42% of these do so because they like it with out any objective reason. Children born and socialized in these families will perceive it normal family and less likely to turn to contraception willingly.