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Balotelli netted twice in six minutes in the first half at The Hawthorns before he made a rapid transformation from hero to villain with a straight red card in the second half for a reckless kick at Youssouf Mulumbu, who was also later sent off.
That dismissal provided evidence of why Balotelli's high-maintenance reputation has dogged his career and Mancini was clearly furious, despite his obvious relief at a first win in four games ahead of their crunch encounter with Manchester United on Wednesday.
City's desperately needed victory inflicted West Brom's first home defeat in the league since January and there were signs that Mancini can indeed challenge for the title with his expensively assembled squad.
In Italian striker Balotelli, he clearly has a maverick talent but one that will test his patience countless times again this season.
Defeat in the Europa League to Lech Poznan in midweek did little to soften the spotlight on Mancini, who is expected to challenge for the title after a massive close-season spending spree.
Three defeats in succession is not the kind of streak City's billionaire owners had in mind when they appointed Mancini and it was crucial that the nosedive was halted as quickly as possible to avoid patience snapping in the boardroom.
A poor turnout from the visiting fans appeared to suggest the faith in Mancini is dwindling. And the opening quarter of an hour was hardly an improvement from their last visit to the Black Country, when they were embarrassed by Wolves.
But once Balotelli stopped picking fights with opponents and concentrating on his reported 180,000 pounds a week wages, City were ahead after 20 minutes.
City were more menacing thanks to the return of Carlos Tevez and his cross from the right found Balotelli at the far post and he bundled the ball over the line.
The shackles appeared to have been removed and Balotelli ruthlessly capitalised on suspect Albion defending from Gabriel Tamas seven minutes later to beat Scott Carson with a low drive.
Albion were second best for large portions of the first half, failing to test England international Joe Hart. But they were improved in the second, with Simon Cox arrowing a splendid 20-yard drive against the upright.
Balotelli's dismissal, a grapple with Mulumbu followed by a rash kick, galvanised the home side but there was to be no gallant fightback as they slipped to only their fourth defeat of the campaign, with Mulumbu also sent off for a foul on Tevez.
