Background <p>Occupational radiation exposure is a known hazard and necessary evil in orthopaedic surgery. Few studies have noted increased female sex ratio amongst the offspring of male orthopaedic surgeons attributed to testicular radiation decreasing the ratio of male sex-determining sperms. </p> Methods <p>A cross-sectional study was conducted by circulating a questionnaire across the Indian Orthopaedic Association. Participants were stratified into high- and low-risk based on sub-speciality and the type as well as method of storing the&#xa0;lead apron. To eliminate recall bias, participants with children aged &lt; 10&#xa0;years were included in a subgroup analysis to ascertain characteristics of work at the time of conceiving their child. Regression analysis was done to determine factors associated with an increased likelihood of a female child. </p> Results <p>A total of 718 biological children of male orthopaedic surgeons were included in this study. 49.6%&#xa0;of children were female, and 48.3% were aged below 10-years. Younger surgeons (age &lt; 50) were noted to have a higher proportion of female children (<i>p</i> = 0.037). Surgeons wearing lead aprons which extended below the knee were more likely to produce a male child (<i>p</i> = 0.025). Regression analysis revealed significant (<i>p</i> = 0.002) number of male children amongst paediatric orthopaedic and pelvi-acetabular surgeons with&#xa0;an odds ratio close to 1. Majority reported inconsistent dosimeter use and lack of formal radiation safety training.</p> Conclusion <p>Younger age of the surgeon and length of lead apron being above the knee significantly correlated with the incidence of having a female child. Radiation safety needs to be integrated into orthopaedic training to promote safe practise.</p>