Low Carb Pizza Casserole

Featured in: Hearty Dinners

This low carb pizza casserole delivers all the flavors of a classic pizza in a hearty, gluten-free and keto-friendly main. Cauliflower stands in for crust while Italian sausage, pepperoni, mushrooms, and green bell pepper ensure every bite is as satisfying as your favorite pie. Layers of marinara sauce and gooey mozzarella fuse for a cheese-lover's dream, complemented with a hint of Italian seasoning. Ideal for quick weeknight dinners or make-ahead meal prep, this bubbly bake is easy to assemble and feeds a crowd without derailing your low carb lifestyle.

Updated on Wed, 16 Jul 2025 18:56:56 GMT
A close up of a delicious pizza with mushrooms and peppers. Save It
A close up of a delicious pizza with mushrooms and peppers. | sunnyspoonful.com

If you crave pizza but want to skip the carbs this low carb pizza casserole delivers all the melty cheesy flavors you love without the crust. Packed with cauliflower Italian sausage pepperoni and loads of mozzarella this one dish wonder keeps things hearty filling and easy for busy nights.

The first time I made this my husband could not believe it was low carb he asked for seconds and then took leftovers for lunch

Ingredients

  • Cauliflower florets: This is the main base use fresh firm white florets for best texture
  • Mushrooms: Add earthy flavor and deliver extra meatiness choose firm dry mushrooms without spots
  • Green bell pepper: Gives a classic pizza bite pick vibrant peppers without wrinkling
  • Italian sausage: Brings spice and richness use quality sausage for the best taste
  • Pepperoni: Classic topping use your favorite brand look for even slices
  • Mozzarella cheese: Essential gooey topping shred your own for best melt
  • Parmesan cheese: Adds nutty sharpness grated or fresh is best
  • Low carb pasta sauce: Look for low sugar count and simple ingredients such as Rao’s Homemade
  • Olive oil: For sautéing choose extra virgin for richer flavor
  • Italian seasoning: Delivers the iconic herb flavor use a fresh batch so it is fragrant

Instructions

Steam the Cauliflower:
Place bite size cauliflower florets in a large microwave safe bowl with one cup water cover with a damp paper towel and microwave on high for three minutes until just fork tender Drain well and pat dry with paper towels to avoid sogginess
Preheat the Oven:
Set your oven to four hundred degrees Fahrenheit or two hundred degrees Celsius so it heats evenly by the time you assemble the dish
Cook the Italian Sausage:
Brown sausage in a large skillet over medium high heat for about fifteen minutes Break it apart with a spoon and cook until no pink remains Drain off any excess fat for a less greasy casserole
Sauté the Mushrooms:
Add olive oil to the same skillet and cook sliced mushrooms over medium high heat for eight to ten minutes Stir often until all moisture evaporates and mushrooms turn golden Set aside
Prepare the Casserole Dish:
Lightly spray a thirteen by nine inch baking dish with nonstick spray Spread half a cup of pasta sauce over the bottom for no stick and extra flavor
Mix the Filling:
Combine steamed cauliflower cooked sausage sautéed mushrooms and green pepper in a large bowl Toss until every piece is coated so flavors mingle
Layer the Casserole:
Add half the mixture to the casserole dish Top with half a cup pasta sauce half the pepperoni slices pressed into the surface and half of the mozzarella cheese
Add Final Layers:
Layer on the remaining vegetable meat mixture Top with last half cup of pasta sauce most of the rest of the pepperoni and the remaining mozzarella cheese
Mix Topping:
Blend Parmesan cheese with Italian seasoning in a small bowl Sprinkle mix evenly across casserole top then finish with reserved pepperoni slices for a true pizza look
Bake It:
Place in the oven and bake for thirty minutes until bubbling and cheese is golden Let rest for five minutes before serving so slices hold shape
A bowl of food with a spoon in it. Save It
A bowl of food with a spoon in it. | sunnyspoonful.com

The mozzarella in this casserole always brings everyone to the table I remember my kids trying to sneak extra cheese when I turn my back for just a second

Storage Tips

Store leftovers in an airtight container in the fridge for up to four days This casserole tastes even better the next day as flavors develop For longer storage cut cooled portions wrap tightly and freeze for up to two months

Ingredient Substitutions

Turkey or chicken sausage works just as well as pork Swap mushrooms for diced zucchini if you dislike mushrooms Dairy free cheese melts well if you need a lactose free swap

Serving Suggestions

Pair with a crisp green salad or steamed broccoli for color A dollop of sour cream or extra hot sauce adds more kick Serve in individual ramekins for a fun party option

Cultural and Seasonal Notes

The classic combination of sausage peppers and cheese is a nod to Italian American pizza culture in the US Winter is the best season for this casserole since cauliflower is sweetest then Holiday gatherings and potlucks are perfect settings since this dish transports well

A close up of a delicious pizza with mushrooms and peppers. Save It
A close up of a delicious pizza with mushrooms and peppers. | sunnyspoonful.com

This low carb pizza casserole is ooey gooey and guaranteed to satisfy your next pizza craving. Give it a try for your next family dinner or meal prep night!

Recipe FAQs

Can I use a different vegetable instead of cauliflower?

You can substitute broccoli, zucchini, or even a blend of low carb vegetables. Adjust the steaming time if using different veggies.

What pasta sauce works best for low carb diets?

Choose sauces labeled sugar-free or no added sugar, such as Rao’s Homemade or similar low carb options for best results.

Is turkey sausage a suitable alternative to Italian sausage?

Yes, turkey sausage lowers the fat content and works well. For added heat, try a spicy variety or add red pepper flakes.

How do I know when the casserole is done baking?

The top should be golden and bubbling, and cheese thoroughly melted. Let it rest a few minutes before serving for neat slices.

How can I make this dish ahead of time?

Assemble the casserole up to a day in advance, cover, and refrigerate. Bake just before serving for best texture and flavor.

What sides pair well with this dish?

A fresh green salad or simple roasted veggies add balance and keep the meal light and nutritious.

Low Carb Pizza Casserole

Satisfy pizza cravings with this cheesy, low carb casserole packed with sausage, pepperoni, and cauliflower.

Prep Time
20 mins
Cook Time
55 mins
Total Duration
75 mins
Authored by Lana Bright

Recipe Type Hearty Dinners

Skill Level Easy

Cuisine Style American

Recipe Yield 10 Serving Size

Diet Preferences Free From Gluten, Low Carbohydrate

What You'll Need

Vegetables

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

Meats

01 2 pounds Italian sausage, casings removed if necessary
02 2.5 ounces pepperoni slices, 10 slices reserved for topping

Cheeses

01 12 ounces mozzarella cheese, shredded, divided
02 1/4 cup Parmesan cheese, grated or powdered

Sauces and Oils

01 1.5 cups low-carb pasta sauce or marinara
02 1 tablespoon olive oil

Seasonings

01 1 teaspoon Italian seasoning

Directions

Step 01

Steam the cauliflower: Place cauliflower florets in a large microwave-safe bowl with 1 cup of water. Cover with a damp paper towel and microwave on high for about 3 minutes until just tender. Do not overcook. Drain well and pat dry with paper towels. Set aside.

Step 02

Preheat the oven: Preheat oven to 400 degrees Fahrenheit.

Step 03

Cook the Italian sausage: In a large skillet over medium-high heat, cook the sausage, breaking it up with a wooden spoon, until browned and cooked through, about 15 minutes. Drain excess fat and set aside.

Step 04

Sauté the mushrooms: In the same skillet, add olive oil and sauté mushrooms over medium-high heat for 8 to 10 minutes until they release and evaporate their moisture. Set aside.

Step 05

Prepare the casserole dish: Spray a 13 by 9 inch casserole dish with non-stick spray, then spread 1/2 cup of pasta sauce over the bottom.

Step 06

Mix cauliflower, meats, and vegetables: In a large mixing bowl, combine steamed cauliflower, cooked sausage, sautéed mushrooms, and green bell pepper. Toss until well mixed.

Step 07

First layer assembly: Layer half of the mixture into the prepared casserole dish. Top with 1/2 cup pasta sauce, half of the pepperoni slices, pressing some between layers, and 6 ounces of shredded mozzarella cheese.

Step 08

Second layer assembly: Layer the remaining vegetable and meat mixture over the cheese. Top with the remaining 1/2 cup pasta sauce, most of the remaining pepperoni, reserving 10 slices for topping, and the remaining 6 ounces mozzarella cheese.

Step 09

Prepare Parmesan topping: In a small bowl, mix together Parmesan cheese and Italian seasoning.

Step 10

Add topping and pepperoni: Sprinkle the Parmesan mixture evenly over the casserole and top with the reserved 10 slices of pepperoni.

Step 11

Bake: Bake in the preheated oven for 30 minutes, or until the casserole is bubbling and the cheese is golden and melted.

Step 12

Rest and serve: Allow to stand for 5 minutes before serving.

Tools You'll Need

  • Large microwave-safe bowl
  • Skillet
  • Large mixing bowl
  • 13 by 9 inch casserole dish
  • Paper towels
  • Wooden spoon or spatula
  • Small bowl
  • Non-stick spray

Allergy Information

Review each ingredient to identify potential allergens, and consult a healthcare professional if you're unsure.
  • Contains dairy from mozzarella and Parmesan cheese.
  • Contains pork from sausage and pepperoni.
  • Potential gluten in sausage or pepperoni if not certified gluten-free.
  • Always check processed ingredient labels for gluten and sugar when preparing for gluten-free or keto diets.

Nutrition Details (Per Serving)

This nutritional data is for reference only and isn't a substitute for medical advice.
  • Caloric Value: 519
  • Fats: 43 grams
  • Carbohydrates: 7 grams
  • Proteins: 27 grams