Balsamo teamed up with Vittoria Guazzini to win the madison with Spain's Sebastian Mora and Albert Torres taking the men's event in Plovdiv.
Italy's Elisa Balsamo and Vittoria Guazzini won the women's madison on on Sunday (15 November), the fifth and final day of the European Track Cycling Championships in Plovdiv.
It was a thriller of a contest with Balsamo taking the final sprint to edge out Russia's Diana Klimova and Maria Novolodskaya by just one point, 52 to 51.
The victory capped a week to remember for the 22-year-old who won the last stage of the Challenge La Vuelta in Madrid last Sunday before travelling to Bulgaria.
She and Guazzini were in the quartet which took team pursuit silver behind Great Britain on Thursday, before Balsamo beat two-time reigning Olympic champion Laura Kenny to claim omnium gold the following day.
Kenny and Elinor Barker took third place for Britain on Sunday with 38 points.
Balsamo told the European Cycling Union, "It was a really hard race and until the end we were very close. The last sprint was very good for us and we are very happy."
Guazzini called their triumph "unbelievable".
She added, "It was really close until the end and I didn't even realise... I saw the points and I was like, 'Oh my God, we can really win!'
"I really wanted to cry with joy because this jersey means a lot for us. It's been a really rough year for everybody and all the hard work has paid off."
They scored 51 points with twin brothers Ivo and Rui Oliveira finishing second for Portugal on 43 points.
Italy's Francesco Lamon and Stefano Moro amassed 33 points for the bronze.
Russia went one and two in the women's 500m time trial courtesy of two members of their victorious team sprint trio.
Shmeleva was dominant with her winning time of 32.720s almost exactly one second clear of the field.
And in the men's 1km time trial, Tomas Babek claimed the Czech Republic's first gold of the week.
The 33-year-old clocked 1:00.517 to take victory from Great Britain's Ethan Vernon with Jonathan Milan in third securing yet another podium finish for Italy.
Britain finished atop the medal table with six gold, three silver, and two bronze medals ahead of Russia whose return of 13 medals - five gold, five silver, and three bronze - was their best ever at the European Track Championships.
Despite a highest total of 14, Italy were third in the table having collected three gold, seven silver, and four bronze medals.