Problem definition: Motivated by a platelet inventory management problem, we study a fixed lifetime perishable inventory management problem under a general demand process. Determining an optimal ordering policy for perishable inventory systems is particularly challenging because of the well-known “curse of dimensionality.” Approximation policies with worst-case performance bounds have been developed in the literature for perishable inventory systems. However, using real data, we observe that the existing policies tend to underorder when the unit shortage penalty is high, which is an important concern for critical perishable products, such as lifesaving blood products. We seek to address this problem in this paper. Methodology/results: We present a new approximation policy for perishable inventory systems, which we call a truncated balancing (TB) policy. In particular, we first define a new balancing ordering quantity and prove a novel lower bound on the optimal ordering quantity. We then define our TB policy such that the maximum between the balancing ordering quantity and the lower bound is ordered at each period. We prove that when first in, first out is an optimal issuing policy, (1) our proposed TB policy admits a worst-case performance bound of two, and (2) it is asymptotically optimal when the unit shortage penalty goes to infinity. Finally, we present a calibrated numerical study based on real data from our partner hospital and show that our proposed policy performs significantly better than the existing policies in practical scenarios with reasonably high shortage penalties. Managerial implications: Our analysis offers managerial insights for perishable inventory management, especially for systems with an imbalance in underage and overage cost parameters. When the unit shortage penalty is high, simply balancing the underage and overage costs can lead to underordering, whereas our proposed policy effectively addresses this drawback. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2022.0644 .