Balakrishna made his acting debut as a child artiste in Tatamma Kala, which was directed by N. T. Rama Rao, his father. He acted in several films, many of which were directed by his father, including Daana Veera Soora Karna (1977), Sri Madvirata Parvam (1979), Akbar Salim Anarkali (1979) and Sri Tirupati Venkateswara Kalyanam (1979). At the age of 16, he acted in a movie titled Annadammula Anubandham (1975), a remake of Dharmendra's Hindi movie Yaadon Ki Baaraat, and played a brother to his real life father, Rama Rao. Balakrishna appeared as son to his real life brother Nandamuri Harikrishna in the movie Dana Veera Sura Karna.
In 1984, he debuted in an adult role with Sahasame Jeevitham. He then starred in the drama film Mangammagari Manavadu the same year, alongside Bhanumathi and Suhasini, directed by Kodi Ramakrishna. In the same year, he acted in Kathanayakudu and in the biographical film Shrimad Virat Veerabrahmendra Swami Charitra. He also appeared in Janani Janmabhoomi in 1984, directed by K. Viswanath. In 1985, he acted with Akkineni Nageswara Rao in the film Bharyabhartala Bandham, alongside Rajani. In 1986, he acted in movies such as Muddula Krishnaiah, Seetharama Kalyanam, Anasuyamma Gari Alludu and Deshoddharakudu, which gradually increased his potential at the box office.[vague]
In 2010, Balakrishna acted in Boyapati Srinu's film Simha, alongside Nayantara and Sneha Ullal. He played a dual role as father and son. The film opened to positive reviews, and went on to become the highest-grossing Telugu film of the year. A review in Rediff said about his performance: \"Balakrishna has put in a restrained performance. Though his character is supposed to roar at times, he seems subdued most of the time. But he's given plenty to be pleased about as it is his show all the way.\" In 2011, he acted in the mythological film Sri Rama Rajyam, based on the epic Ramayana. He played a triple role in the 2012 action drama Adhinayakudu as grandfather, father and grandson. Balakrishna was the chief guest for the 43rd International Film Festival of India, 2012. In 2014, he acted in Boyapati Srinu's film Legend, alongside Sonal Chauhan and Jagapathi Babu. He played the title role in the biographical and historical film Gautamiputra Satakarni, his 100th film. The film is directed by Krish and is based on the life of the 2nd century ruler of the Satavahana dynasty, Gautamiputra Satakarni. In 2018, he acted in Jai Simha, which was directed by K. S. Ravikumar and started shooting for the N.T.R. biopic in which he reprised the role of his father. The film was made in two parts, the first part NTR: Kathanayakudu was released on 9 January 2019, with the second NTR: Mahanayakudu on 22 February 2019. His 2021 movie Akhanda marks third collaboration with director Boyapati Srinu, featuring his dual role as Aghori Baba and a farmer. It was a super hit at the box office.
In 2012 the Governor of Goa, B. V. Wanchoo, the Chief Minister Manohar Parrikar and Balakrishna were seen along with award winners and other dignitaries at the closing ceremony of the 43rd edition of the IFFI. Balakrishna, in his speech, said that although the Telugu film industry finds no place in the film festival by way of representation its films, 80 percent of the movies that are produced in India are in regional languages, out of which Fifty percent are from South India. \"Today, film industry is facing competition from radio, and television as also from piracy,\" he stated. He also maintained that the film festivals have enlarged his vision towards his career. 1e1e36bf2d