During the 1990s, the sex ratio at birth increased considerably and simultaneously in the three independent Caucasian countries, Armenia, Azerbaijan, and Georgia. At the end of the first decade of the twenty-first century, levels remain abnormally high in Armenia and Azerbaijan (above 114 male births per 100 female births) and show erratic trends in Georgia. Analyzing data from demographic surveys carried out around 2005, we confirm the persistence of high sex ratios in these three countries and document significant differences in fertility intentions and behavior according to the sex of the previous child or children that constitute evidence of the practice of sex-selective abortion. These countries combine societal features and medical systems that make this phenomenon possible: son preference in a context of low fertility and the possibility of prenatal sex selection given easy access to ultrasound screening and induced abortion. Why high sex ratios are observed only in these three countries of the sub-region remains, however, an open question.