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By relying on the number of (surviving) boys per hundred girls observed in the population censuses as a cumulative measure of differential mortality during birth, infancy, and childhood, this paper shows that average Italian child sex ratios (aged 0–4) were abnormally high between 1861 and 1921. Our estimations indicate that unexplained excess female mortality resulted in around 2–3 per cent of ‘missing girls’ during this period. Likewise, by constructing a new dataset on child sex ratios at the provincial level during the same period, this article shows that child sex ratios tended to be higher in Southern Italy, a geographical cleavage that became stronger as time went by. Crucially, the results reported here cannot be explained by registration issues because (1) the analysis holds if we focus on the sex ratios of older children (aged 5–9) and (2) these patterns are also clearly visible using death registers. Unexplained excess female mortality early in life disappeared from the 1920s onwards, thus suggesting that either discriminatory practices gradually vanished and/or that they no longer translated into higher mortality rates due to enhanced living standards.