Background: Balloon dilation of the Eustachian tube traditionally employs specialized devices, limiting accessibility and increasing costs. This study evaluated the feasibility and safety of using standard endovascular balloons for this procedure.Methods: A prospective, single-center study enrolled 75 adults with chronic Eustachian tube dysfunction. Standard endovascular balloons were used for dilation under general anesthesia. Primary outcomes included technical success and safety. Secondary outcomes included changes in ETDQ-7 scores, tympanometric parameters, and patient satisfaction at 6 weeks post-procedure.Results: Technical success was achieved in 96% of cases. ETDQ-7 scores improved significantly from 4.8 ± 0.9 to 2.1 ± 0.6 (p<0.001) at 6 weeks. The complication rate was 34.7%, predominantly minor and self-limiting, with 92.3% resolution within 6 weeks. Type A tympanograms increased from 0% to 77.3% at 6 weeks (p<0.001). Mean air-bone gap improved from 28.5 ± 8.4 dB to 12.8 ± 5.4 dB (p<0.001). Younger age (≤45 years, OR=1.8, p=0.023) and shorter symptom duration (≤12 months, OR=2.4, p=0.002) predicted better outcomes. Patient satisfaction reached 92% with mean recovery time of 3.2 days.Conclusion: Eustachian tube balloon dilation using standard endovascular balloons demonstrates favorable safety and efficacy profiles, offering a potentially cost-effective alternative to specialized devices.