The present study demonstrates the use of bilateral internal iliac artery balloon occlusion (BIIABO) as a preventative measure in the management of high-risk molar pregnancies undergoing surgical evacuation of the uterus. The present study reports the case of a 27-year-old female, gravida 1 para 0, who presented with an ultrasound scan indicative of hydatidiform mole and a ß-human chorionic gonadotropin level of 2,263,570 IU/l. Due to her pre-operative anaemia and increase levels of blood markers, she was considered as having a high-risk of haemorrhage and was thus treated with BIIABO, whilst undergoing the surgical evacuation of the uterine contents. Bilateral internal iliac artery balloons were inserted, and the uterine contents were successfully evacuated. To the best of our knowledge, this is the first study exploring the use of BIIABO as a preventative measure in the management of women with hydatidiform mole who are at risk of severe bleeding. [ABSTRACT FROM AUTHOR]