Child underreporting is often neglected in studies of fertility and sex ratio imbalance in China. To improve estimates of these measures, I use intercensal comparisons to identify a rise in underreporting, which followed the increased enforcement and penalization under the birth planning system in 1991. A new triangulation of evidence indicates that about 19% of children at ages 0–4 were unreported in the 2000 census, more than double that of the 1990 census. This evidence contradicts assumptions underlying the fertility estimates of most recent studies. Yet, the analysis also suggests that China’s fertility in the late 1990s (and perhaps beyond) was below officially adjusted levels. I then conduct a similar intercensal analysis of sex ratios of births and children, which are the world’s highest primarily because of prenatal sex selection. However, given excess underreporting of young daughters, especially pronounced just after 1990, estimated ratios are lower than reported ratios. Sex ratios in areas with a “1.5-child” policy are especially distorted because of excess daughter underreporting, as well as sex-linked stopping rules and other factors, although it is unclear whether such policies increase use of prenatal sex selection. China’s sex ratio at birth, once it is standardized by birth order, fell between 2000 and 2005 and showed a continuing excess in urban China, not rural China.