Balsom previously won the young classical performer award
Trumpeter Alison Balsom has become the first British woman to win best female at the Classical Brit awards.
Balsom, 30, who won the young British classical performer in 2006, said: "This award means so much to me."
The Royal Scots Dragoon Guards won the prestigious album of the year for Spirit of the Glen: Journey, recorded during their tour of duty in Iraq.
The event, at London's Royal Albert Hall, also saw opera star Jose Carerras pick up a lifetime achievement award.
Dame Kiri Te Kanawa, Placido Domingo and the Duchess of Cornwall presented Carreras with his gong.
"Let me tell you that I see myself as a very fortunate man," Carerras said.
He added that expressing himself through his voice was "something I think I was born for".
Maj Angus Benson-Blair, of the Royal Scots Dragoon Guards, dedicated the prize to "everyone in the armed forces".
It is the first time that non-professional musicians have won a Classical Brit.
Their album is also the first instrumental recording to win album of the year.
Singer Aled Jones, 38, said it was good for the industry.
"I think it's only good for a competition like the Classical Brits that a group as professional and lacking in pretentions as the Dragoon Guards has won album of the year," he said.
The album of the year prize is voted for by Classic FM listeners and readers of Classic FM magazine, who choose from a list of the Top 10 selling classical albums of the past year.
In a year which saw him lead the Simon Bolivar Youth Orchestra at sell-out UK concerts, Venezuelan conductor Gustavo Dudamel won the award for male artist of the year.
Violinist Alina Ibragimova, a former Russian who moved to England in 1996, was the winner of young British classical performer award - previously won by Alison Balsom in 2006.
Soundtrack of the year went to Hans Zimmer and James Newton Howard for their work on Batman sequel The Dark Knight
Nominated in two categories this year, conductor Sir Charles Mackerras was the recipient of the critics' award.
Chosen by a panel of journalists from the national media, the award is for Mozart Symphonies nos. 38-41 performed by the Scottish Chamber Orchestra.
The 83-year-old veteran conductor won two BBC Music Magazine awards earlier this year for the same recordings.
Composer of the Year was awarded to Howard Goodall for Eternal Light - A Requiem, his first Classical Brit.
Performers on the night included 13-year-old former Britain's Got Talent finalist Faryl Smith who opened the show with River Of Light.