Limited studies have focused on fertility preferences in Pakistan and these have used mostly cross-sectional surveys. This study utilized all available datasets from 1975 to 2013 to investigate the fertility preferences in Pakistan. Explicit findings of this study show that preferred family size is quite high at four children per woman, has stagnated in the last four decades, and does not vary greatly between urban and rural areas. Son preference in the family is the principal predictor of the desired family size and women tend to adjust their ideals upward as the number of living children increases, in order to rationalize the birth. There is little indication that women in Pakistan are moving away from the four-child ideal and acceptance of an ideal of having two children is limited. Finally, several methodological issues have hindered a thorough analysis of fertility preferences. There is a greater need to generate in-depth datasets to understand the fertility intentions and preferences in Pakistan.