OBJECTIVES: The objective of the study was to evaluate the budget impact of shifting the treatment for menorrhagia in Canadian hospitals from rollerball to thermal balloon ablation. Thermal balloon ablation procedures can be completed in an ambulatory care setting as compared to rollerball procedures, which must be carried out in the operating room. The aim of this study was to determine whether shifting procedures from rollerball to thermal balloon ablation would present a hospital with cost savings on a per patient basis.   METHODS: A budget impact model was created and populated using case-costing data from several large Canadian hospitals. The two procedures were compared in terms of device cost, use of resources and nursing costs. The cost of treatment using rollerball and thermal balloon ablation were compared to determine the number of procedures that could be completed using each device for the same total cost.  RESULTS: Based on model calculations the total cost per patient to treat menorrhagia using rollerball is $1,977.58 and the total cost per patient to treat menorrhagia using thermal balloon ablation is $1,415.46.  The use of thermal balloon ablation allows for a hospital savings of $562.12 per patient treated. The use of thermal balloon ablation would enable a Canadian hospital to treat approximately 70 patients with menorrhagia for the same total cost as treating 50 patients with rollerball.  CONCLUSIONS: The use of thermal balloon ablation for the treatment of menorrhagia allows for a cost savings per patient when compared with rollerball.