Christopher Clay Rudd was scheduled to appear before a judge in Spanish Fork, Utah, on Monday after he was arrested for drug offences.
Video shows the 35-year-old, stand up and walk out of the courtroom with no one attempting to stop him except a bailiff who runs after Rudd who walks out.
Rudd then appears to purposely throw himself over a guardrail and falls around 20 feet onto a tiled floor in the lobby. Police officers are unable to catch the inmate as he drops to the ground.
Lieutenant Matt Johnson said inmates appearing at the court would now be required to wear leg restraints.
Rudd suffered head and hip injuries during the fall and was later taken to hospital for treatment. Rudd is due to appear back at the courthouse later in May, when he may face additional charges over the balcony plunge.