Background: Male gender preference is a dominant feature of Igbo culture and could be the reason behind women seeking fetal gender at ultrasound. Aim: The aim of this study is to investigate the perception of prenatal ultrasound patients of male gender preference in a patriarchal and gender sensitive society. Subjects and Methods: The study was a cross‑sectional survey, which targeted pregnant women who presented for prenatal ultrasound at four selected hospitals in Anambra State. A convenience sample size of 790 pregnant women constituted the respondents. The data collection instrument was a 13‑item semi‑structured self‑completion questionnaire designed in line with the purpose of the study. Descriptive and inferential statistical analyses were carried out with statistical significance being considered at P < 0.05. Results: Most of the women (88.4%, 698/790) were aware that fetal gender can be determined during the prenatal ultrasound while just over half of them (61.0%, 482/790) wanted fetal gender disclosed to them during prenatal ultrasound. More than half (58.6%, 463/790) of the women desired to have male babies in their present pregnancies while 20.1% (159/790) desired female babies and 21.3% (168/790) did not care if the baby was male or female. Some of the women (22.2%, 175/790) wanted to have male babies in their present pregnancies for various reasons predominant of which was protecting their marriages and cementing their places in their husbands’ hearts. Male gender preference was strongly perceived. There was considerable anxiety associated with prenatal gender determination and moderate loss of interest in the pregnancy associated with disclosure of undesired fetal gender. Socio‑demographic factors had significant influence on perception of male gender preference. Conclusion: Male gender preference is strongly perceived among Igbo women and its perception is significantly influenced by socio‑demographic factors. Male gender preference may be responsible for Igbo women seeking fetal gender at ultrasound.