AbstractWe describe a double‐balloon technique for performing a percutaneous balloon pericardiotomy. This technique was employed when the large, single dilation balloon customarily used for this procedure failed to fully inflate across the parietal pericardium. Two smaller balloons were advanced through the same skin tract and simultaneously inflated, thus producing an adequate pericardial window. This double‐balloon technique allowed for the more secure anchoring of the balloons across the pericardium and for the delivery of greater dilation pressures. © 1995 Wiley‐Liss, Inc.