The current study examined the long-term trend in sex ratio at birth between 1929 and 1982 using retrospective birth histories of 310 101 Chinese women collected in a large, nationally representative sample survey in 1982. The study identified an abrupt decline in sex ratio at birth between April 1960, over a year after the Great Leap Forward Famine began, and October 1963, approximately 2 years after the famine ended, followed by a compensatory rise between October 1963 and July 1965. These findings support the adaptive sex ratio adjustment hypothesis that mothers in good condition are more likely to give birth to sons, whereas mothers in poor condition are more likely to give birth to daughters. In addition, these findings help explain the lack of consistent evidence reported by earlier studies based on the 1944–1945 Dutch Hunger Winter or the 1942 Leningrad Siege.