Low Carb Pizza Casserole

This hearty low-carb pizza casserole delivers all the classic pizza flavors you crave without the carbs. Perfect for family dinners, this casserole combines the savory goodness of Italian sausage, pepperoni, and melty cheese with nutritious vegetables for a satisfying meal that won't derail your low-carb lifestyle.

I first created this recipe when my family decided to reduce our carb intake but couldn't bear giving up our weekly pizza night. This casserole quickly became a staple in our home and my kids actually prefer it to regular pizza now, especially when they get to help choose the toppings.

• Cauliflower florets (14 ounces): The perfect low-carb substitute for pasta or pizza crust providing a neutral base that absorbs flavors well
• Mushrooms (8 ounces): Adds earthy flavor and meaty texture choose cremini for deeper flavor or white button for milder taste
• Green pepper (1): Provides freshness and slight crunch look for firm peppers with glossy skin
• Italian sausage (2 pounds): Delivers rich savory flavor and protein select quality sausage with visible herbs and spices
• Pepperoni (2.5 ounces): Gives that classic pizza flavor choose a nitrate-free variety for healthier option
• Mozzarella cheese (12 ounces): Creates that stretchy gooey pizza experience use whole milk mozzarella for best melting
• Parmesan cheese (1/4 cup): Adds umami depth and salty bite opt for freshly grated when possible
• Low-carb pasta sauce (1.5 cups): Forms the base of pizza flavor choose a brand with under 5g carbs per serving
• Olive oil (1 tablespoon): For sautéing extra virgin provides best flavor
• Italian seasoning (1 teaspoon): Infuses authentic pizza herb flavor blend should include oregano basil and thyme

How To Make Low Carb Pizza Casserole

Prepare the cauliflower:

Place cauliflower in a microwave-safe bowl with water and cover with damp paper towel. Microwave for 3 minutes until tender but still slightly firm. This parcooking technique ensures the cauliflower won't release excess moisture into your casserole. After cooking drain thoroughly and pat completely dry with paper towels to prevent a watery casserole.

Cook the protein:

Brown Italian sausage in a large skillet over medium-high heat for about 15 minutes breaking it into small pieces as it cooks. Watch for even browning and continue cooking until no pink remains. Drain fat completely to prevent greasy casserole. The properly browned sausage creates a foundation of flavor for the entire dish.

Prepare the mushrooms:

In the same skillet add olive oil and sauté mushrooms over medium-high heat. Cook for a full 10 minutes allowing them to release their moisture and then develop golden edges. This concentrates their flavor and prevents excess liquid in the final dish. Stir occasionally for even cooking.

Layer the base:

Coat a 13x9 inch casserole dish with nonstick spray and spread a thin layer of pasta sauce on the bottom. This prevents sticking and builds flavor from the bottom up. Ensure even coverage with the sauce reaching all corners of the dish.

Mix and layer ingredients:

Combine cauliflower sausage mushrooms and peppers in a large bowl tossing gently but thoroughly. Spread half this mixture in the dish then add sauce pepperoni and cheese. The layering creates distinct flavor zones similar to a traditional lasagna allowing each ingredient to shine.

Complete assembly:

Add remaining vegetable mixture then build final layers with remaining pepperoni sauce and cheese. This creates a beautiful presentation with golden cheese on top. Mix Parmesan with Italian seasoning for the final sprinkle creating a flavorful crust when baked.

Bake to perfection:

Bake at 400°F for 30 minutes until bubbling around edges and cheese is melted with golden spots. The high temperature ensures proper browning while allowing flavors to meld together. Let rest 5-10 minutes before serving to set properly.

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The Italian sausage is truly the star of this recipe. I discovered that using a high-quality sausage with noticeable fennel seeds and herbs makes all the difference. My family was skeptical about a pizza without crust but after one bite everyone was converted. Now I keep portions in the freezer for busy weeknights when pizza cravings hit.

Perfect Substitutions

This recipe welcomes customization just like your favorite pizza. For a spicier version substitute half the Italian sausage with hot Italian sausage or add red pepper flakes to the sauce. Vegetarians can replace the meat with plant-based alternatives or simply double the mushrooms and add zucchini for bulk. Dairy-free eaters can use dairy-free cheese alternatives though they won't melt quite as beautifully as traditional mozzarella.

Storage Solutions

This casserole keeps beautifully in the refrigerator for up to 4 days making it perfect for meal prep. Store individual portions in airtight containers for grab-and-go lunches. For longer storage freeze portions for up to 3 months. When freezing I recommend using freezer-safe glass containers and leaving a half-inch of space at the top for expansion. Thaw overnight in the refrigerator before reheating in a 350°F oven until heated through about 20 minutes.

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Serving Suggestions

While this casserole is substantial enough to be a complete meal on its own pairing it with complementary sides elevates the dining experience. A simple green salad dressed with olive oil and lemon juice provides a refreshing contrast to the rich casserole. For family members not following low-carb diets garlic bread makes a perfect accompaniment. I often serve this at gatherings alongside both low-carb and traditional options and find that everyone gravitates toward this casserole regardless of their dietary preferences.

Frequently Asked Questions

→ Can I use a different vegetable instead of cauliflower?

Yes, you can substitute cauliflower with broccoli or zucchini for a similar texture and flavor. Adjust cooking time as needed to avoid overcooking.

→ What type of pasta sauce works best?

A low-carb marinara or pizza sauce, such as Rao's Homemade Marinara, is ideal for its rich flavor and keto-friendly profile.

→ Can I make this dish ahead of time?

Yes, you can assemble the casserole a day in advance and refrigerate it. Bake as instructed when ready to serve.

→ What other cheeses can I use?

You can substitute mozzarella with provolone, cheddar, or a blend of Italian cheeses for a slightly different flavor profile.

→ Is this casserole freezer-friendly?

Yes, store the fully cooked casserole in a freezer-safe container for up to 3 months. Reheat in an oven until heated through.