Ballmer leads a local workforce of nearly 41,000 -- and more than twice that worldwide -- and his leadership directly effects the local economy.
But former executive Joachim Kempin said the company has gone astray and needs to get back to its roots.
"It's no longer a nimble company," he said.
When Kempin started at Microsoft there were just 400 employees. When he left that number had skyrocketed to 50,000.
As senior vice president in charge of sales to PC makers, Kempin saw a lot and made a lot of money.
But now, 11 years after he left, Kempin has written a rare tell-all book about the senior levels of Microsoft and the mistakes he believes they've made.
For one thing, Kempin doesn't think the Xbox gaming console is worthwhile to the company.
"I think it's a mistake," he said.
He believes Bill Gates had the right attitude about getting things done, but also said the current company is faltering.
"There's no real technical leader inside the company," he said. "That's a real issue that they have."
He puts much of the blame on his former co-worker, Steve Ballmer.
Asked if he thinks Ballmer is the right man for the job, Kempin said, "I think he's a great COO. as CEO I think he needs to have more of a technical vision."
Ballmer has been under fire from Wall Street for Microsoft's flat stock performance, but the company still makes billions in profits from its core software, such as Windows and Office.
Ballmer and Microsoft are betting big that the Xbox and its a new Surface tablet will be profit centers. But German-born Kemplin, who knows the PC market extremely well, said it's a bad bet.
"Hardware margins are extremely thin compared to software margins," he said.
He believes Microsoft needs to stick to making good software not just for Windows, but for all platforms, including social media.
"When it comes to social media in particular, Microsoft is nowhere," he said.
Kempin said when Gates was CEO, employees were allowed more freedom to innovate. Under Ballmer, he said that's not the case.
"Steve likes to control you more, and that was a huge difference, at least for me and other people," he said.
He said Ballmer stymied innovation, rather than fostering it.
"Sometimes he comes into a conference room with a baseball bat, right. I can take that, but some people can't," he said.
Kempin's critics say he's more than a decade removed from Microsoft and doesn't know the current inner workings. Still, he continues to be a company booster. He said he just wants to revive that start-up spirit he experienced when was there.
Microsoft declined to comment on Kempin's remarks and his book, called "Resolve and Fortitude."