He made his debut in a 2–2 draw against Catania, during the 2012–13 season. He scored his first goal for Roma in the Derby della capitale match against Lazio, on 22 September 2013; Roma won the game 2–0. During his second season at the club, however, Balzaretti suffered a severe case of athletic pubalgia following Roma's match against Sassuolo, on 10 November 2013, which threatened to end his career; due to the pain in his pelvis, he had to undergo several operations. He finally returned to the pitch on the final match of the 2014–15 season, in a 2–1 home defeat to his former club Palermo, on 31 May 2015.