Summary: We report a series of women (n = 16) with menorrhagia undergoing endometrial balloon ablation under local analgesia with light sedation. Ten women had significant, coexistent medical problems. The median duration of the procedure was 8.6 minutes (range 8.47–9.5 minutes). Postoperative assessment included pain scores assessed by linear analogue scale; requirement for opiate analgesia; length of postoperative stay and patient satisfaction with the procedure. The minimum postoperative follow-up was 6 months. The procedure was well-tolerated and in 80% of cases either no postoperative analgesia or simple analgesia only was required. Two women were admitted overnight, 1 for social reasons and the other for pain control. Three women ages 44, 54 and 55 years were amenorrhoeic at 6 months; 8 women were still menstruating but satisfied with the outcome and 5 women are seeking further treatment for menorrhagia. While the longer-term efficacy of the procedure remains to be established these results indicate that endometrial balloon ablation under local analgesia and light sedation, a simple and acceptable technique, may be a suitable alternative to more difficult procedures such as rollerball ablation. This is most likely to be the case in appropriately selected women who are willing to accept a reduction in menstrual flow rather than amenorrhoea as the treatment outcome. The main disadvantage of balloon ablation is the cost of the disposable balloons and the need for a dedicated electrosurgical unit.