A balance approach is presented to solve one-dimensional multiple stock size cutting stock problem with setup cost. The approach first utilizes a sequential pattern generation algorithm to generate a series of cutting plans based on each stock size, respectively. Then, a measure standard of cost balance utilization is used to select a current optimized cutting pattern from a cutting plan corresponding to each stock size. All item demands are dealt by the previous two steps to obtain many optimized cutting plans, and an ideal cutting plan is extracted according to the minimum sum of stock and setup costs at last. The approach is applied to two tests, and the computational results demonstrate that it possesses good cost adaptability and optimization performance.