Baldwin IV was dying of leprosy. He had his nephew Baldwin of Montferrat crowned as his co-king. It was Balian who carried on his shoulder, in his office as Chamberlain of Jerusalem, the eight-year-old boy in that ceremony, due to his height. However, the boy Baldwin died less than year later following his uncle the king.

In the year 1187 Balian narrowly escaped both the disastrous Battles of Cresson and Hattin. In advance of the Siege of Jerusalem he asked Saladin for permission to send his wife and their children away to Tripoli. Saladin granted his permission. It fell to Balian to organize and command the defense of the holy city. After twelve days on October 2nd, 1187, Balian surrendered the city to Saladin for the promise that many of the Crusaders, their families and other Christians could leave unmolested.

This event triggered the Third Crusade. Balian continued to serve the Crusader kingdoms with the army of Richard the Lionheart at the Battle of Jaffa. Afterward he helped negotiate the treaty of Ramla in 1192. Balian died in 1193 at the castle Caymont, a gift from Saladin.