diff --git a/litellm/caching/redis_cache.py b/litellm/caching/redis_cache.py
index afe6f8a1eab..264eec189be 100644
--- a/litellm/caching/redis_cache.py
+++ b/litellm/caching/redis_cache.py
@@ -130,7 +130,8 @@ _CALL_STACK_END_MODULES: Final = ("asyncio", "concurrent", "threading")
 _INCREMENT_WITH_FLOOR_LUA: Final = (
     "local count = redis.call('INCRBY', KEYS[1], ARGV[1]) "
     "if count < 0 then count = redis.call('INCRBY', KEYS[1], -count) end "
-    "if redis.call('TTL', KEYS[1]) < 0 then redis.call('EXPIRE', KEYS[1], ARGV[2]) end "
+    "if count == 0 then redis.call('DEL', KEYS[1]) return 0 end "
+    "redis.call('EXPIRE', KEYS[1], ARGV[2]) "
     "return count"
 )
 
@@ -962,10 +963,11 @@ class RedisCache(BaseCache):
         keeps it safe: a separate corrective write could land after another pod's increment and
         erase it.
 
-        The TTL is set only on a key that has none, so a counter expires ``ttl`` after it was
-        created rather than ``ttl`` after it was last touched. Refreshing it on every touch
-        would keep a count a dead worker never decremented alive for as long as the group
-        takes traffic. Returns the resulting count.
+        The TTL is refreshed on every touch while the count is positive, and the key is
+        deleted when the count hits zero. That keeps a busy deployment's counter from
+        expiring mid-flight (which used to let later decrements undercount it for
+        least-busy routing). A counter a dead worker never decremented still ages out
+        once the deployment goes idle for ``ttl`` seconds. Returns the resulting count.
         """
         namespaced_key: Final = self.check_and_fix_namespace(key=key)
         count: Final[object] = self.redis_client.eval(  # pyright: ignore[reportAttributeAccessIssue]  # stubs omit eval
diff --git a/tests/integration/routing/test_redis_increment_with_floor.py b/tests/integration/routing/test_redis_increment_with_floor.py
index d5535d30715..9df27081d84 100644
--- a/tests/integration/routing/test_redis_increment_with_floor.py
+++ b/tests/integration/routing/test_redis_increment_with_floor.py
@@ -34,7 +34,7 @@ def test_a_decrement_past_zero_leaves_the_counter_at_zero(counter: tuple[RedisCa
     assert cache.batch_get_counts([key]) == (0,)
 
 
-def test_traffic_never_pushes_a_counters_expiry_back_out(counter: tuple[RedisCache, str, str]) -> None:
+def test_traffic_refreshes_a_counters_expiry(counter: tuple[RedisCache, str, str]) -> None:
     cache, key, namespaced_key = counter
 
     cache.increment_with_floor(key, 1, TTL)
@@ -43,17 +43,17 @@ def test_traffic_never_pushes_a_counters_expiry_back_out(counter: tuple[RedisCac
     cache.redis_client.expire(namespaced_key, 30)
     cache.increment_with_floor(key, 1, TTL)
 
-    assert cache.redis_client.ttl(namespaced_key) <= 30
+    assert cache.redis_client.ttl(namespaced_key) > 30
 
 
-def test_clamping_to_zero_keeps_the_expiry_it_already_had(counter: tuple[RedisCache, str, str]) -> None:
+def test_clamping_to_zero_deletes_the_counter(counter: tuple[RedisCache, str, str]) -> None:
     cache, key, namespaced_key = counter
 
     cache.increment_with_floor(key, 1, TTL)
     cache.redis_client.expire(namespaced_key, 30)
 
     assert cache.increment_with_floor(key, -5, TTL) == 0
-    assert cache.redis_client.ttl(namespaced_key) <= 30
+    assert cache.redis_client.exists(namespaced_key) == 0
 
 
 @pytest.mark.asyncio
@@ -64,6 +64,36 @@ async def test_the_async_counter_behaves_the_same_way(counter: tuple[RedisCache,
     assert await cache.async_batch_get_counts([key]) == (2,)
 
     cache.redis_client.expire(namespaced_key, 30)
+    assert await cache.async_increment_with_floor(key, 1, TTL) == 3
+    assert cache.redis_client.ttl(namespaced_key) > 30
 
     assert await cache.async_increment_with_floor(key, -9, TTL) == 0
-    assert cache.redis_client.ttl(namespaced_key) <= 30
+    assert cache.redis_client.exists(namespaced_key) == 0
+
+
+def test_ongoing_traffic_keeps_an_in_flight_counter_from_expiring(
+    counter: tuple[RedisCache, str, str],
+) -> None:
+    """Under load, #48994's fixed-from-creation TTL let the counter expire while
+    requests were still in flight. Refreshing the TTL on every touch keeps the
+    count aligned with the real in-flight set for as long as the deployment is busy.
+    """
+    import time
+
+    cache, key, namespaced_key = counter
+    short_ttl = 2
+
+    for _ in range(3):
+        cache.increment_with_floor(key, 1, short_ttl)
+    assert cache.redis_client.get(namespaced_key) == b"3"
+
+    # Keep touching for longer than the TTL. Old behavior would expire the key and
+    # the next +1/-1 pair would rebuild from zero; new behavior keeps the count at 3.
+    deadline = time.monotonic() + short_ttl + 1.0
+    while time.monotonic() < deadline:
+        cache.increment_with_floor(key, 1, short_ttl)
+        cache.increment_with_floor(key, -1, short_ttl)
+        time.sleep(0.2)
+
+    assert cache.redis_client.get(namespaced_key) == b"3"
+    assert cache.redis_client.ttl(namespaced_key) > 0