
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

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

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.