He formed The Presidents of the United States of America in 1994 with David Dederer, with whom he had gone to middle and high school at The Bush School in Seattle. Ballew collaborated in the early 1990s with Mark Sandman of Treat Her Right and Morphine in a duo called Supergroup, in which they developed the oddly-stringed instruments that would become a staple of both the Presidents' and Morphine's sound.

The Presidents of the United States of America debut album went double platinum, rocketed all the way to #6 on Billboard's Top 200 Album Chart, produced three Top 40 hits ("Lump", "Kitty" and "Peaches") and a #1 single on Billboard's Modern Rock Chart, and garnered two Grammy nominations and a gaggle of critical praise for its sense of pop savvy and quirkiness. Their videos blanketed MTV, they toured the planet, played a live MTV concert at Mount Rushmore, and appeared on The Late Show with David Letterman, The Tonight Show with Jay Leno, Late Night with Conan O'Brien, The Howard Stern Show and Dick Clark's Rockin' New Year's Eve. As if that weren't enough, II spawned another top-ten Modern Rock hit, Mach 5, and the band contributed a rocking cover of "Video Killed the Radio Star" to the platinum-selling soundtrack to Adam Sandler's The Wedding Singer. At the end of the line, Pure Frosting, the band's swan song for Columbia, included a cover of the Ian Hunter song "Cleveland Rocks", which was used for many seasons as the theme song to the Emmy-nominated television series, The Drew Carey Show. For the average artist, such achievements usually mark the summation of a long and healthy career if they're lucky. The Presidents, however, accomplished all that and more in just a couple of years.

Their newest release "Love Everybody" was released in 2004.