BACKGROUND Childlessness is a global concern and it has serious demographic, social, and health implications. The declining Muthuvan child population may reduce their population on the whole. OBJECTIVE The study explored the prevalence of childlessness and its underlying reasons in the Muthuvan tribes of Tamil Nadu. METHODS The study applied the mixed-method design, and the snowball technique was adopted to identify eight Muthuvan hamlets. Descriptive and thematic analysis was done for the collected quantitative and qualitative information. RESULTS The study found the prevalence of childlessness among Muthuvan couples as 30.65%. The underlying reasons were their cultural practices of confinement during menstruation and restriction on engaging in productive work and family care, which gave them the idea of regular intake of oral contraceptive pills and lessen their desire to have children. CONCLUSIONS The study concludes that the comfort of their daily life has taken over more important than the consequences of objects used for comfort, to their health and future generations.