This report initiates from an initiative of the UNFPA a year ago in December 2011, when for the first time, in a conference in Albania, the issue of sex imbalances and sex selection at birth was discussed in the context of Albanian populations. Academics, national and international, policy makers, experts from the international community as well as civil society discussed the relevance and the issues related to the sex imbalance amongst Albanians at the start of the 21st century. One of the overwhelming conclusions of this conference was how little we know regarding this issue in Albania in particular and in the Balkans in general, at a time when the demography of the country and the region has been detailed for a very long time. It was recommended that more research needed to be done in this area focusing on three important aspects of the sex imbalance at birth and sex selection.