It has been suggested that bearing sons increases long-term mortality in women, because sons may be more physiologically demanding to produce than daughters. In this historical cohort study in rural Bangladesh, no association between the number of sons born and mortality was seen in women in the unadjusted analyses. However, a significant reduction in mortality with the number of surviving sons was seen. In addition, after adjusting for the number of surviving sons, there was evidence of increasing mortality with the number of sons born, in women. In men, mortality also depended strongly on the number of surviving sons, but not on the number born. These data provide support for negative long-term costs of bearing sons in mothers in rural Bangladesh, and suggest that there are context-specific factors that mask the true effects of sons in some populations.