Low Carb Pizza Casserole

Featured in Satisfying Hearty Mains.

This Low Carb Pizza Casserole is a delightful combination of flavors perfect for those following low-carb or keto lifestyles. This gluten-free dish features tender cauliflower florets, savory Italian sausage, fresh mushrooms, green peppers, and hearty mozzarella cheese blended with a rich low-carb marinara sauce. Layered and baked to a golden perfection, it's a satisfying dinner option that offers all the deliciousness of pizza without the carbs. Simple to prepare and bursting with flavor, this casserole provides a wholesome, crowd-pleasing meal for any occasion.

emliy for recipes by clare
Updated on Thu, 01 May 2025 12:02:30 GMT
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This hearty low carb pizza casserole brings all the mouth-watering flavors of pizza without the carbs. Perfect for those following keto or gluten-free diets, this casserole is packed with protein, veggies, and of course, cheese. One bite and you will forget you are enjoying a low carb meal.

I developed this recipe during my own keto journey when I desperately missed pizza night with my family. Now it's requested more often than traditional pizza, even by my carb-loving teenagers.

Ingredients

  • Italian Sausage: provides rich flavor and hearty texture as the protein base
  • Cauliflower: replaces traditional pasta for a low carb option that still provides satisfying texture
  • Mushrooms: add umami depth and meaty texture choose cremini for enhanced flavor
  • Green Pepper: brings fresh crunch and classic pizza flavor
  • Pepperoni: delivers that authentic pizza experience with spicy notes
  • Low Carb Pasta Sauce: watch labels carefully Raos Homemade Marinara has minimal added sugars
  • Mozzarella Cheese: creates that stretchy pizza experience use full-fat for best flavor
  • Parmesan Cheese: adds savory complexity to the topping
  • Italian Seasoning: ties everything together with classic pizza herbs

Step-by-Step Instructions

Steam the Cauliflower:
Cut cauliflower into bite sized pieces then place in a microwave safe bowl with water and cover with a damp paper towel. Microwave for approximately 3 minutes until just tender but not mushy. This quick cooking method preserves texture while ensuring the cauliflower integrates well with other ingredients.
Brown the Sausage:
Cook Italian sausage in a large skillet over medium high heat breaking it into crumbles as it cooks. Take your time with this step about 15 minutes to ensure the sausage develops a nice caramelization which adds significant flavor depth. Drain excess fat to prevent your casserole from becoming greasy.
Sauté the Mushrooms:
Add olive oil to the same skillet you used for the sausage and cook mushrooms thoroughly for 10 minutes. This extended cooking time removes excess moisture which prevents a watery casserole. The mushrooms will shrink considerably and develop a concentrated flavor.
Layer the Casserole:
Start with pasta sauce on the bottom of your prepared baking dish then add half the protein veggie mixture. Continue building flavor layers with more sauce pepperoni and a generous helping of mozzarella. Repeat layering ending with a special Parmesan and Italian seasoning blend for an extra flavorful crust.
Bake to Perfection:
Bake at 400°F for 30 minutes until bubbly and golden. Allow the casserole to rest for 5 minutes before serving this helps the layers set and makes serving easier. Look for bubbling edges and a slightly browned top as indicators of doneness.
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The cauliflower is my secret weapon in this recipe. I was skeptical at first about using it as a pasta replacement, but its neutral flavor and ability to soak up the Italian seasonings won me over completely. My husband actually commented that this casserole has more flavor than regular pizza because every bite contains all the toppings.

Make-Ahead and Storage Tips

This pizza casserole actually improves in flavor when made a day ahead. Prepare all steps up to baking, cover tightly with foil, and refrigerate for up to 48 hours. When ready to enjoy, bake as directed, adding about 10 minutes to the cooking time since you're starting from cold.

Leftovers store beautifully in airtight containers in the refrigerator for up to 4 days. For longer storage, portion cooled casserole into freezer-safe containers and freeze for up to 3 months. Thaw overnight in the refrigerator before reheating in a 350°F oven until hot throughout.

Perfect Pairings

Serve this pizza casserole alongside a simple arugula salad dressed with olive oil and lemon juice for a complete meal. The peppery greens provide a nice contrast to the rich casserole. For those not counting carbs, garlic bread makes an excellent accompaniment for family members with higher carb allowances.

For a pizza night experience, set out small bowls of additional toppings like red pepper flakes, fresh basil, and extra Parmesan cheese so everyone can customize their portion. This interactive element makes dinner more fun, especially for children.

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Topping Variations

This versatile recipe welcomes endless customization. Try these popular variations for different flavor experiences:

  • Meat Lovers Version: add crispy bacon and diced ham to the existing proteins
  • Veggie Supreme: incorporate olives, onions, and diced zucchini
  • Buffalo Chicken: substitute shredded chicken tossed in buffalo sauce for the Italian sausage
  • Mediterranean Style: use feta cheese, olives, and artichoke hearts

Frequently Asked Questions

→ Can I use a different vegetable instead of cauliflower?

Yes, you can substitute cauliflower with broccoli or zucchini, both of which work well with the other ingredients in this casserole.

→ What type of marinara sauce should I use?

Choose a low-carb marinara sauce, such as Rao's Homemade, to keep the dish keto-friendly and flavorful.

→ Can I make this dish ahead of time?

Yes, you can assemble the casserole a few hours ahead and refrigerate it. Bake it just before serving for the best results.

→ How can I store leftovers?

Store leftovers in an airtight container in the refrigerator for up to 3 days. Reheat in the oven or microwave before enjoying.

→ Can I use ground beef instead of Italian sausage?

Absolutely, ground beef is a great alternative. Add extra seasoning, like garlic or dried oregano, to amplify flavor.

→ Is this dish kid-friendly?

Yes, many kids will enjoy this dish since it has familiar pizza flavors. You could leave out ingredients like mushrooms if they are less preferred.

→ Can I make this dish vegetarian?

You can make it vegetarian by omitting the sausage and adding more vegetables like spinach, zucchini, or eggplant.

Low Carb Pizza Casserole

Savor all your favorite pizza flavors in this low-carb, gluten-free casserole packed with hearty, delicious ingredients.

Prep Time
20 Minutes
Cook Time
55 Minutes
Total Time
75 Minutes

Category: Hearty Mains

Difficulty: Intermediate

Cuisine: American

Yield: 10 Servings

Dietary: Low-Carb, Gluten-Free

Ingredients

→ Vegetables

01 14 ounces cauliflower florets, cut into bite-size pieces
02 8 ounces mushrooms, sliced
03 1 green pepper, cut into bite-size pieces

→ Protein

04 2 pounds Italian sausage, casings removed if applicable
05 2.5 ounces pepperoni

→ Dairy

06 12 ounces mozzarella cheese, shredded
07 1/4 cup Parmesan cheese, powdered

→ Condiments & Sauces

08 1.5 cups low-carb pasta sauce, such as Rao's Homemade Marinara

→ Spices & Oils

09 1 tablespoon olive oil
10 1 teaspoon Italian seasoning

Instructions

Step 01

Place the cut cauliflower in a microwave-safe bowl with 1 cup of water. Cover with a damp paper towel and microwave on high for approximately 3 minutes or until the cauliflower is tender but not overcooked.

Step 02

Drain the cauliflower and pat dry with paper towels. Set aside.

Step 03

Preheat oven to 400°F (200°C).

Step 04

In a large skillet over medium-high heat, cook the Italian sausage for about 15 minutes. Drain excess fat and set aside.

Step 05

In the same skillet, add olive oil and sauté mushrooms over medium-high heat for 10 minutes to remove excess water. Set aside when done.

Step 06

Spray a 13x9 inch casserole dish with non-stick spray. Spread ½ cup of pasta sauce on the bottom of the dish.

Step 07

In a large bowl, combine the cauliflower, cooked Italian sausage, mushrooms, and green peppers. Toss together until well mixed.

Step 08

Spread half of the mixture in the casserole dish. Top with ½ cup of pasta sauce, followed by half of the pepperoni slices (press them slightly between the toppings), and 6 ounces of shredded mozzarella cheese.

Step 09

Spread the remaining mixture on top of the cheese, followed by the remaining pepperoni slices (reserving 10 slices for the topping), the rest of the pasta sauce, and the remaining 6 ounces of mozzarella cheese.

Step 10

In a small bowl, mix together the Parmesan cheese and Italian seasoning. Sprinkle the mixture over the top of the casserole, then add the 10 reserved pepperoni slices.

Step 11

Place the casserole in the preheated oven and bake for 30 minutes, or until the dish is heated through and the cheese is fully melted.

Notes

  1. Each serving contains 4 net carbs, making it suitable for a low-carb or keto diet.

Tools You'll Need

  • Microwave-safe bowl
  • Large skillet
  • Damp paper towel
  • Casserole dish (13x9 inch)
  • Mixing bowl

Allergy Information

Please check ingredients for potential allergens and consult a health professional if in doubt.
  • Contains dairy (mozzarella and Parmesan cheese).
  • May contain gluten if non-certified pasta sauce is used.

Nutrition Facts (Per Serving)

It is important to consider this information as approximate and not to use it as definitive health advice.
  • Calories: 519
  • Total Fat: 43 g
  • Total Carbohydrate: 7 g
  • Protein: 27 g