diff --git a/litellm/llms/gemini/realtime/transformation.py b/litellm/llms/gemini/realtime/transformation.py
index edc6dac6f4a..36e11b011e8 100644
--- a/litellm/llms/gemini/realtime/transformation.py
+++ b/litellm/llms/gemini/realtime/transformation.py
@@ -686,18 +686,12 @@ class GeminiRealtimeConfig(BaseRealtimeConfig):
         verbose_logger.debug(
             f"Gemini Realtime: Transforming {len(function_calls)} tool call(s) to OpenAI format"
         )
-        has_multiple_calls = len(function_calls) > 1
-        
         return [
             {
                 "type": "response.function_call_arguments.done",
                 "event_id": f"event_{uuid.uuid4()}",
                 "response_id": resolved_response_id,
-                "item_id": (
-                    f"{resolved_output_item_id}_tool_{idx}"
-                    if has_multiple_calls
-                    else resolved_output_item_id
-                ),
+                "item_id": f"{resolved_output_item_id}_tool_{idx}",
                 "output_index": idx,
                 "call_id": fc.get("id", ""),
                 "name": fc.get("name", ""),
diff --git a/tests/test_litellm/llms/gemini/realtime/test_gemini_realtime_transformation.py b/tests/test_litellm/llms/gemini/realtime/test_gemini_realtime_transformation.py
index 97b9d58597e..c3e43e4a2c5 100644
--- a/tests/test_litellm/llms/gemini/realtime/test_gemini_realtime_transformation.py
+++ b/tests/test_litellm/llms/gemini/realtime/test_gemini_realtime_transformation.py
@@ -338,7 +338,7 @@ def test_gemini_realtime_tool_call_transformation():
     assert function_call_event["call_id"] == "call_123"
     assert function_call_event["name"] == "get_weather"
     assert function_call_event["response_id"] == "resp_123"
-    assert function_call_event["item_id"] == "item_123"
+    assert function_call_event["item_id"] == "item_123_tool_0"
     assert function_call_event["output_index"] == 0
     
     # Verify arguments are properly serialized as JSON string
@@ -579,6 +579,8 @@ def test_gemini_realtime_multi_tool_calls_have_unique_item_ids():
     assert len(responses) == 2
     assert responses[0]["response_id"] == "resp_123"
     assert responses[1]["response_id"] == "resp_123"
+    assert responses[0]["item_id"] == "item_123_tool_0"
+    assert responses[1]["item_id"] == "item_123_tool_1"
     assert responses[0]["item_id"] != responses[1]["item_id"]
     assert responses[0]["output_index"] == 0
     assert responses[1]["output_index"] == 1