<p>Research investigating association between patriarchy and demographic behavior is limited in India. The only study on this subject utilized 1981 Indian Census data to examine associations between patriarchy and fertility. We examined the association of patriarchy, measured using India Patriarchy Index (IPI), with total fertility rate (TFR) and excess female child mortality in India. Additionally, we examined independent associations of the 5 dimensions included in the IPI with the two outcomes. We used univariate and bivariate Local Indicators of Spatial Autocorrelation, multivariable ordinary least squares and spatial error- regressions to examine the associations. Spatial heterogeneity beyond the north–south divide was evident in the spatial association of IPI with TFR and excess female child mortality. Results show positive association of IPI with TFR and excess female child mortality. While son preference and socio-economic domination were positively associated with TFR, domination of men over women and son preference were positively associated with excess female child mortality. This study is the first of its kind to examine the association of a novel measure of patriarchy with TFR and excess female child mortality. As patriarchy is deep-rooted in Indian society, a great deal of effort is needed to shift these traditionally held social norms and practices.</p>