Background: Fertility is determined by many factors, so there are variations in pregnancies, births. Family size varies within, between societies. Socioeconomic status, environment, culture, education, couples’ understanding, every day life play vital roles. Objectives: Present study was done to know sterilization practices by couples of rural, tribal communities of Melghat region Amravati, Maharashtra, India. Materials and methods: Study subjects were 520 married women of 20-35 years. If non pregnant then with one or more births, at least one live child. If pregnant then with second pregnancy onwards, willing to give consent for providing desired information as per predesigned, pretested questionnaire in local language. Results: Of 520 women, 198 had one live child, no one had sterilization. There was hardly any birth spacing/planning, except occasional use of condom by educated, very few. Of 322 women with 2 or more live children, only 77 (26%) had sterilization, no vasectomy. Two hundred women had 2 live children, 43 (21.5%) of them had sterilization, 122 had >2 live children, only 34 (28%) had sterilization. Only 17 (13.9%) of 122 women had sterilization with 1 male and 1 female child, none with no male child, irrespective of number of female children, Mostly women had sterilization after 3 male children, 60 of 77 (77.92%) had sterilization after 2 or more male children. Conclusion: Fertility was high creating more problems for tribal communities with extremely low resources. Only women underwent sterilization. Not only son was essential, there was desire of more than 2 male children. It is essential to create awareness about advantages of small families for health, social, economic aspects and about gender equity.