Low Carb Pizza Casserole
Low Carb Pizza Casserole is a gluten-free, keto pizza casserole packed with all of your favorite pizza flavors without the carbs!
This Low Carb Pizza Casserole has solved all of my pizza-craving problems! Packed with all of the flavors of pizza, sauce, pepperoni, sausage, mushrooms, peppers, and lots and lots of cheese this delicious pizza casserole skips the traditional pasta and substitutes it with cauliflower.
It’s a gluten-free, keto dinner casserole similar to our, Keto Chicken Alfredo Casserole, Keto Big Mac Casserole, Keto Taco Casserole, and Keto Buffalo Chicken Casserole. All are simple to make and so good that the whole family will love them, even if they aren’t cutting carbs.
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What is in Keto Pizza Casserole?
- Cauliflower
- Pepperoni
- Italian Sausage – You’ll want to use ground Italian sausage. If you have to buy Italian sausage that is in casings (sausage links) just remove the meat from the casings before cooking.
- Mushrooms
- Green Bell Pepper
- Mozzarella cheese
- Low Carb Pasta Sauce – We love Rao’s Homemade Marinara sauce. It has no added sugar and it’s only 4 grams of net carbs per 1/2 cup. Feel free to use whatever sauce you like. Just remember it may change the carb count of the finished meal.
- Parmesan cheese
- Italian Seasoning
As with any low carb recipe you’ll want to check the nutritional information on the products you use, especially the pasta sauce, and the Italian sausage.
As I mentioned we used Rao’s Homemade Marinara which is 4 net carbs per 1/2 cup. The Italian sausage we used was bought in the fresh meat section of the local grocery store and was approximately 1 carb per link (I removed the meat from the casings before cooking).
The great thing about pizza is that there are so many ways to make it. Feel free to customize this baked pizza casserole with any of your favorite pizza toppings (as long as they are low carb!).
Other Low Carb Pizza Toppings:
- Ham
- Bacon
- Chicken
- Ground Beef
- Genoa Salami
- Artichoke Hearts
- Spinach
- Jalapenos
- Pepperonicinis
- Black Olives
- Goat Cheese
- Blue cheese
How to Make Low Carb Pizza Casserole:
- Steam the cauliflower. I like to keep things quick and easy so I steam mine in the microwave. Place 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. Don’t overcook it! You don’t want mushy cauliflower, you just want it to be slightly tender so it won’t have to cook so long in the oven.
- Drain the cauliflower pat dry with a paper towel. Set aside.
- In a large skillet over medium high heat cook the Italian sausage, approximately 15 minutes. When the sausage has finished cooking drain the excess fat. Set aside.
- In the same skillet add olive oil and saute the sliced mushrooms for 10 minutes. This will help remove some of the excess water. Set aside when done.
- Prepare a 13 x 9 inch casserole dish by spraying it with non-stick spray then spread ½ cup of pasta sauce on the bottom.
- In a large bowl add the cauliflower, cooked Italian sausage, mushrooms, and green peppers. Toss together until well mixed.
- Spread ½ of the mixture in the casserole dish. Top with ½ cup of pasta sauce, followed by ½ of the pepperonis (kind of press them down in between the other toppings), and finally 6 ounces of mozzarella cheese.
- Next spread the remaining toppings mixture over the cheese followed by the pepperonis (save 10 slices for the top of the casserole), remaining ½ cup of pasta sauce, and 6 ounces of mozzarella cheese.
- In a small bowl mix together the Parmesan cheese and Italian seasoning.
- Sprinkle the Parmesan mixture over the casserole and top with 10 slices of pepperoni.
- Place in the oven and bake at 400 degrees F. for 30 minutes, or until the casserole is warmed through and the cheese is fully melted.
Looking for More Low Carb and Keto Dinner Ideas?
- Keto Tacos
- Keto Buffalo Chicken Cauliflower Casserole
- Big Mac Keto Meatloaf
- Low Carb Meatloaf
- Low Carb Chicken Cordon Blue Casserole
- Low Carb Jalapeno Chicken and Broccoli Casserole
- Instant Pot Butter Chicken
- Low Carb Moo Shu Pork
- More Low Carb & Keto Recipes…
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Low Carb Pizza Casserole
Ingredients
- 14 ounces Cauliflower florets, cut into bite-size pieces
- 2.5 ounces Pepperoni
- 2 pounds Italian Sausage, if in casings remove from casing before cooking
- 1 tablespoon Olive Oil
- 8 ounces Mushrooms, sliced
- 1 Green Pepper, cut into bite-size pieces
- 12 ounces Mozzarella cheese, shredded
- 1.5 cups Low Carb Pasta Sauce, we use Rao’s Homemade Marinara
- 1/4 cup Parmesan cheese, powdered
- 1 teaspoon Italian Seasoning
Instructions
- Steam the cauliflower. Place 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. Don’t overcook!
- Drain the cauliflower pat dry with a paper towel. Set aside.
- Preheat oven to 400 degrees F.
- In a large skillet over medium high heat cook the Italian sausage, approximately 15 minutes. When the sausage has finished cooking drain the excess fat. Set aside.
- In the same skillet at olive oil and saute mushrooms over medium high heat for 10 minutes to remove the excess water. Set aside when done.
- Prepare a 13×9 inch casserole dish by spraying it with non-stick spray then spread ½ cup of pasta sauce on the bottom.
- In a large bowl add the cauliflower, cooked Italian sausage, mushrooms, and green peppers. Toss together until well mixed.
- Spread ½ of the mixture in the casserole dish. Top with ½ cup of pasta sauce, followed by ½ of the pepperonis (kind of press them down in between the other toppings), and finally 6 ounces of mozzarella cheese.
- Next spread the remaining toppings mixture over the cheese followed by the pepperonis (save 10 slices for the top of the casserole), remaining ½ cup of pasta sauce, and 6 ounces of mozzarella cheese.
- In a small bowl mix together the Parmesan cheese and Italian seasoning.
- Sprinkle the Parmesan mixture over the casserole and top with 10 slices of pepperoni.
- Place in oven and bake for 30 minutes, or until the casserole is warmed through and the cheese is fully melted.
Made this today, it was awesome! I added much more cheese and pepperoni. At my daughter’s suggestion, on half of it I put cauliflower tots on top and the last 2 minutes of baking I turned on the broiler. The tots got a little crispy and acted as a crust for the pizza.
Great idea!
That sounds like a great idea, I just made it, but ran out of mozzarella cheese, didn’t have much, so I mixed cream cheese, shredded cheddar & creamy garlic cheese. I sure hope it turns out. I did add more pepperoni than last time.
Thank you for the tot suggestion ❤️
Can u freeze this?
We did & it was just as good as the day I made it😊
We just had this tonight, and it was delicious, but it was very salty. Any suggestions for lower sodium options?
There is no added salt so it may be the type of sauce you used. The powdered parm is a little salty too, you may cut that in half. Hope that helps.
Mine was very salty too, I think it may have been the sausage I used. Next time I make it I’ll use half sausage half turkey to see if that helps
One of our favorite low carb casseroles! Wanting to try freezing one. Do you know how it freezes?
This looks great! Does anyone know how many servings are in this dish? Thanks!
The calories seem very high for a serving on this casserole. What exactly is a serving size?
Hi Tena, this recipe has 2 pounds of Italian sausage in it which adds a lot of calories. We divided the casserole into 10 equal pieces for a total of 10 servings.
Can you make this ahead of time and refrigerate?
Yes, I have some in my fridge right now. I just microwave leftovers. My boyfriend reheats it in the air fryer and it’s amazing too.
Easy prep… substituted spinach and onion for mushrooms (didn’t feel like running to the store). Came together in a snap.
Delicious!!
That’s an awesome idea!! I’m not a huge mushroom fan so that would be perfect!!!
You are using cauliflower florets instead of riced cauliflower, right? Do you only use fresh cauliflower? Is frozen allowed? Some recipes I use specifically say whether you can use frozen, or if only fresh works (bc of too much water in the frozen)… My husband is already salivating as I’m making the grocery list for this, so I don’t want to F it up. 😂
Hi Ellie, we used fresh which is why you have to steam it a little before baking. I haven’t used frozen but I’m sure you could. I would thaw it first so you can remove any excess water so your casserole doesn’t get watery (there will always be a little even with fresh cauliflower)
Made this tonight and it was delicious, didn’t even miss the crust! I did use 1 lb. ground Italian sausage and 1 lb. ground sirloin to get the 2 lb.’s of meat. I also added in some onions because we like them on our pizza. Everyone loved it so I will be making it again. Thanks for sharing your recipe.
I used cauliflower rice and halfed the sausage. I also used onion, garlic ctushed and spinach. It was awesome. Thank you
Sounds delicious to me, but…my husband does not like cauliflower 😕 wondering if you think it would work with broccoli?
Yes that’s a great substitute.
Do you saute the green pepper and onion also or put them in raw???
You can add them in raw.
New to low carb /keto life. Made this for my family and it was a hit. If keto/low carb is this good, I am in. Thank you for the recipe!
Could you make this in the crock pot (so it could be taken to work and kept warm)?
I would not recommend making it in a slow cooker. I worry it would be too watery and mushy.
Made it!!! Wow! Super easy and mega yummy. Even reheated well in the microwave. Will be adding this to our weekly menu.
My husband can’t have much vitamin K due to blood thinners. Is there another substitute for the cauliflower that is low carb? Thanks!
Hi Sherry, you could just add more of the bell peppers and mushrooms and increase the meat.
So…….this was good but I mistakenly thought the cauliflower would form a “crust” of sorts.
When I started making it I realized it was all mixed together. Again, it was good, tasted just like pizza. I must always tell myself from now on, read through the entire recipe before I make it!
I made this tonight and it is DELICIOUS. My picky husband even gobbled it up. I did something wonky though, because I ended up with a lot of juice in the bottom of the casserole dish. Any ideas as to why or how to avoid it?
Hi April, so glad you liked it! Cauliflower, and any other vegetables, release water as they cook. We try to eliminate some of that by steaming the cauliflower ahead of time and patting it dry before adding it to the casserole but some liquid will still get released. Also some sauces have more water than others. If you felt it was too watery try sauteing any vegetables you add to remove excess moisture before baking (mushrooms are especially watery) and make sure the cauliflower is patted dry before adding it.
This is absolutely delicious and satisfies any pizza cravings. Add a green salad and it makes for a really nice Italian dinner. Thanks for the recipe!
My family reacts to all things cauliflower. Is broccoli a possible substitute?
You can sub it out for something like cauliflower.
Delicious meal! I made mine in cast-iron and it turned out perfectly! Thanks for the recipe, it’ll be in our rotation! I’ll post my photo on pinterest.
So glad you liked it!
Excellent. I substituted the pork for turkey. Aded a few extra pepperoni and the rest is history!
I can never get enough mushroom 🍄 flavor!! So, I started using large portabello mushrooms as my base!!! It also helps for portion control!
That’s an awesome idea!! I’m not a huge mushroom fan so that would be perfect!!!
This has become a family favorite. I accidentally bought cauliflower rice one time. Happy accident. Now I use cauliflower rice every time
This recipe is seriously amazing! I only had half the amount of meat so I doubled the mushroom for extra protein and added diced red onion. So much flavor and definitely do not miss the crust. Highly recommend, super easy to throw together!
Made this today. So good. I did cut back on the sausage using only 1 pound. I did add onion and a couple of jalapeños. Will definitely be making this again. I also made it into 6 servings since I cut back on the sausage. Husband appreciated the serving size. Thanks for the great recipe!
Just a thought for those of you that found the sausage too salty. Try using mild chicken sausage. It has a very nice taste and not too salty. I was surprised how good the chicken sausage is. Very tasty.
We LOVE this! It’s our go-to dish when we crave pizza! It’s delicious as leftovers as well!
Excellent and very forgiving recipe. I use it as a base and clean out my veggie drawer when I make it. I wanted to share that my cauliflower HATING husband tried this to humor me and he loved it. He likes it better the second day. So, I encourage you to give the cauliflower a chance!