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Home » Dinners

Best Easy Keto-Friendly Italian Sausage Casserole

Published: Jul 27, 2025 · Modified: Aug 22, 2025 by Lauren Williford · This post may contain affiliate links · Leave a Comment

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Sometimes finding the perfect low carb meal can being boring, but this Keto Italian Casserole is anything but that. It's creamy, has flavorful spicy sausage and ricotta and is sure to be a crowd pleaser!

keto italian casserole

This is one of my favorite italian recipes and one that the entire family is sure to love!

Great Keto Option: If you love the comfort food taste of keto sloppy joes, but don't want a low-carb meal, this recipe has the perfect versatility to meet your keto diet criteria. It's a hearty casserole without the guilt and one of my favorite casserole recipes!

Easy Meal for Busy Weeknights: This keto sloppy joe recipe can be made in under 30 minutes and is perfect for an easy weeknight meal the whole family will love! I love making it during the summer months or when it's a busy time of year.

Ultimate Comfort Food: This recipe surprised me so much because of how comforting it was! The flavors are bold and warm, but the best part is the lettuce is light, for the perfect meal that's not too heavy!

Jump to:
  • Ingredients
  • Instructions
  • Substitutions
  • Equipment
  • Storage
  • Top Tip
  • Related
  • Desserts
  • Best Easy Keto-Friendly Italian Sausage Casserole
  • Author

Ingredients

keto italian sausage casserole
  • Ground hot italian sausage
  • Whole milk ricotta cheese
  • Sour cream
  • Zucchini noodles
  • Italian seasoning
  • Fresh basil
  • Parmesan grated or italian cheese blend
  • Red onion
  • Fresh spinach
  • Garlic powder
  • Olive oil
  • Flaky sea salt

See recipe card for quantities.

Instructions

keto italian casserole

Step 1: Preheat the oven to 350°F. Add 1 teaspoon of salt to the zucchini spirals, mix the salt evenly over the noodles in a bowl and let sit for 10 minutes to pull out the water. 

italian zucchini casserole

Step 2: Heat a large skillet to medium-high heat and add 1 tablespoon of olive oil. Sauté the hot italian sausage, red onions and ½ teaspoon flaky sea salt. Break down the ground hot italian sausage with a wooden spatula and cook for about 5-7 minutes until cooked through. When finished cooking, drain any excess liquid, remove the mixture from the skillet and set aside.

keto italian casserole

Step 3: Turn the skillet, back to medium-high heat and add 1 teaspoon of olive oil. Sauté the spinach for 2-3 minutes until wilted, remove from heat and drain any excess liquid.

keto italian casserole

Step 4: Wrap the zucchini noodles in paper towels and squeeze the excess liquid so they are as dry as possible. This is the best way to draw the water out of the zucchini to prevent the casserole from having a runny texture.

italian zucchini casserole

Step 5: In a medium bowl, combine spinach, garlic powder, italian seasoning, fresh basil, ricotta, sour cream and 1 teaspoon of sea salt.

italian sausage casserole

Step 6: Add 1 teaspoon of olive oil to a 9x13 large casserole dish or large baking dish and spread evenly around the bottom and edges of the dish.

For the first layer, add half of the ricotta mixture to the large baking dish.

keto italian casserole

Step 7: Then layer with all of the zucchini noodles.

italian zucchini casserole

Step 8: Layer the hot Italian sausage mixture.

italian sausage casserole

Step 9: Then layer with the remaining ricotta mixture and top with the Parmesan cheese.

italian zucchini casserole

Step 10: Bake in the oven for 35-45 minutes until the cheese is fully melted, golden brown and the center of the casserole is no longer cool. If the casserole is starting to burn before it finishes cooking, cover with aluminum foil until it finishes baking.

Top with fresh basil and Parmesan cheese before serving.

Substitutions

Spice: If you want to make this recipe have an extra kick add some red pepper flakes on top or serve with Calabrian chili paste!

Cheese: I am using a four cheese blend from trader joe's for my recipe, but you can easily use parmesan or mozzarella cheese instead!

Italian Keto Beef Casserole: Sausage not your thing? You can easily substitute the hot Italian sausage for hot Italian beef or ground beef.

If you are looking for other Keto recipes, be sure to try my The Best Keto Big Mac Casserole with Special Sauce, Best Keto Sloppy Joe Casserole Recipe - Delicious or my Honey Ginger Soy Salmon recipe for a great low carb option!

Equipment

  • 9x13 large casserole dish
  • Zucchini sprialer
  • Large skillet

Storage

Store in an airtight container in the fridge for up to 3 days.

Top Tip

You can easily turn this Keto Italian Casserole in an easy freezer meal. Once the casserole is assembled, instead of baking, simply wrap tightly in a freezer safe container and plastic wrap.

Once you are ready to bake, place uncovered in the oven at 350°F. Bake for an hour or until the center is no longer cool. If the casserole is starting to burn before it finishes cooking, cover with aluminum foil until it finishes baking.

Related

Looking for other recipes like this? Try these:

  • bread bowl clam chowder recipe
    Clam Chowder Bread Bowl Recipe - 40 g Fiber per Batch
  • lentil potato soup
    Easy Lentil Potato Soup Recipe - with High Fiber
  • keto sloppy joes
    Best Keto Sloppy Joe Casserole Recipe - Delicious
  • big mac keto casserole
    The Best Keto Big Mac Casserole with Special Sauce

Desserts

These are my favorite desserts to serve with this recipe:

  • rainbow ice cream cake
    Amazing Chocolate Chip Cookie Rainbow Ice Cream Cake
  • valentines sugar cookies
    Incredible Lofthouse Style Frosted Sugar Cookies
  • almond olive oil cake
    Almond Olive Oil Cake
italian zucchini casserole

Best Easy Keto-Friendly Italian Sausage Casserole

Dinner Dessert Repeat
Sometimes finding the perfect low carb meal can being boring, but this Keto Italian Casserole is anything but that. It's creamy, has flavorful spicy sausage and ricotta and is sure to be a crowd pleaser!
Print Recipe Pin Recipe
Prep Time 20 minutes mins
Cook Time 45 minutes mins
Total Time 1 hour hr 5 minutes mins
Course Main Course
Cuisine Italian
Servings 4

Ingredients
  

For the Casserole:

  • 1 lb ground hot italian sausage
  • 16 oz whole milk ricotta cheese
  • 6 oz sour cream
  • 3 zucchinis spiraled into noodles or 20 oz ounces zucchini noodles
  • 1 teaspoon italian seasoning
  • ¼ c fresh basil chopped
  • 5 oz parmesan grated or italian cheese blend
  • ½ red onion chopped
  • 6 oz fresh spinach
  • 1 teaspoon garlic powder
  • 2 tablespoon olive oil 1 teaspoon olive oil spinach

For the Topping:

  • Fresh basil
  • Parmesan cheese

Instructions
 

  • Preheat the oven to 350°F. Add 1 teaspoon of salt to the zucchini spirals, mix the salt evenly over the noodles in a bowl and let sit for 10 minutes to pull out the water.
  • Heat a large skillet to medium-high heat and add 1 tablespoon of olive oil. Sauté the hot italian sausage, red onions and ½ teaspoon flaky sea salt. Break down the ground hot italian sausage with a wooden spatula and cook for about 5-7 minutes until cooked through. When finished cooking, drain any excess liquid, remove the mixture from the skillet and set aside.
  • Turn the skillet, back to medium-high heat and add 1 teaspoon of olive oil. Sauté the spinach for 2-3 minutes until wilted, remove from heat and drain any excess liquid.
  • Wrap the zucchini noodles in paper towels and squeeze the excess liquid so they are as dry as possible. This is the best way to draw the water out of the zucchini to prevent the casserole from having a runny texture.
  • In a medium bowl, combine spinach, garlic powder, italian seasoning, fresh basil, ricotta, sour cream and 1 teaspoon of sea salt.
  • Add 1 teaspoon of olive oil to a 9x13 large casserole dish or large baking dish and spread evenly around the bottom and edges of the dish.
  • Add half of the ricotta mixture then layer the zucchini noodles, hot Italian sausage mixture, the remaining ricotta mixture and then top with the Parmesan cheese.
  • Bake in the oven for 35-45 minutes until the cheese is fully melted, golden brown and the center of the casserole is no longer cool. If the casserole is starting to burn before it finishes cooking, cover with aluminum foil until it finishes baking.
  • Top with fresh basil and Parmesan cheese before serving.
Keyword Italian Zucchini Casserole, Keto Italian Casserole
Tried this recipe?Let us know how it was!

Author

  • Lauren Williford

    View all posts

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