Born in Palermo, Sicily, Balestrere initially settled with his family in Milwaukee, in spring 1903. When he was a teenager, his family moved to the Kansas City area. Balestrere became a bigshot in the Kansas City outfit during Prohibition. Though a stone mason by trade, he is believed to have teamed with Joseph DiGiovanni and his brothers in a bootlegging-related venture, supplying sugar to moonshine operations.