[3] A few sources state he began boxing as early as 1918 with the Army, but Ballerino's first known bout in the Philippines was in January 1920 against Kid Ponzo, which he won in a third-round knockout.
Rising to face top-rated opponents quickly, he met future Filipino World Flyweight Champion Pancho Villa nine times between January 1920, and October 1921 losing to him in six bouts.
His primary opponent in the Philippines, Pancho Villa arrived in America to fight the following year, with the assistance of legendary manager and promoter Tex Rickard.
Ballerino would not make the top of boxing cards often until taking the championship, though near the end of his career he would fight a number of name boxers in front of larger audiences.
[1][6] On October 25, 1922, he fought Seattle bantamweight Buddy Ridley at the Auditorium in Tacoma, in a bout that was pre-determined as a six-round draw at the insistence of Ballerino's manager Eddie Tait.
On June 18, 1923, he lost to Jewish lightweight Charley Goodman in a six-round points decision at the Polo Grounds in New York, a venue for well-attended, popular bouts.
[1] He fought Vincent "Pepper" Martin, an important opponent, for the first time in a non-title fight on June 24, 1924, winning in a twelve-round points decision at the Nostrand Athletic Club in Brooklyn, New York.
[1] Still in line for a shot at the title, on July 15 and August 5, 1924, Ballerino fought Jr. Lightweight Championship contender Allentown Johnny Leonard in Brooklyn, New York, winning both non-title fights in 10 and 12 round points decisions.
[1] Ballerino fought a Jr. Lightweight Championship against Steve "Kid" Sullivan on December 15, 1924, at the Auditorium in Milwaukee, Wisconsin, in a ten-round newspaper decision.
[1] In a World Jr. Lightweight rematch on April 1, 1925, Ballerino won a unanimous decision against his frequent rival Steve Sullivan at the Armory in Philadelphia, Pennsylvania, in a bout that went the full ten rounds.
On June 24, 1925, he retained his championship going ten full rounds to a draw with local boxer Babe Ruth in Philadelphia, Pennsylvania, at the Phillies Baseball Park before 10,000 satisfied fans.
[16] He successfully defended the title on July 6, 1925, against Vincent "Pepper" Martin in a fifteen-round unanimous decision at Queensborough Stadium in Queens, New York.
[1][13] Ballerino lost the Jr. Lightweight Title on December 2, 1925, in a ten-round technical knockout against Tod Morgan at Olympic Auditorium in Los, Angeles.
[17] The Associated Press wrote that Ballerino's seconds had his manager Frank Churchill threw in the towel, though they already knew Morgan had clinched the bout on points.
[1] On September 30, 1926, he fought highly rated boxer Eddie Lord at Nutmeg Stadium in New Haven, Connecticut, winning in a ten-round points decision.
[1] On March 18, 1927, Ballerino began a five-match losing streak that ended with his last fight against Maxie Strub in Conneaut Lake, Pennsylvania, on June 27, 1928.