Low-Carb Pizza Casserole is a rich, comforting, and flavor-packed dish that delivers all the satisfaction of classic pizza without the heavy carb load. Instead of a traditional dough crust, this casserole uses tender cauliflower or other low-carb vegetable bases to create a hearty, cheesy meal that fits perfectly into ketogenic or low-carb lifestyles. It is customizable, easy to prepare, and ideal for weeknight dinners or meal prep.

Classic Low-Carb Pizza Casserole

This version uses cauliflower as the main base, providing volume and texture while staying low in carbs. Combined with savory sausage, melted cheese, and classic pizza toppings, this casserole tastes indulgent while remaining health-conscious.

Prep Time: 20 minutes
Cook Time: 35–40 minutes
Servings: 6

Ingredients

Cauliflower Base

1 large head cauliflower (about 2 lbs), cut into small florets
Salt and black pepper to taste

Meat and Sauce Layer

1 lb Italian sausage (mild or hot), casings removed
½ cup onion, chopped
2 cloves garlic, minced
1 jar (15 oz) sugar-free pizza sauce or marinara
½ of the pepperoni slices from a 4 oz package
1 cup shredded mozzarella cheese
½ cup shredded Parmesan cheese
1 teaspoon dried oregano
½ teaspoon red pepper flakes (optional)

Final Topping

1 cup shredded mozzarella cheese
Remaining pepperoni slices
Fresh basil or parsley for garnish (optional)

Instructions

Prepare the Cauliflower

Preheat the oven to 375°F (190°C). Steam the cauliflower florets until tender but not overly soft, about 8–10 minutes. Alternatively, microwave them in a covered dish with a splash of water for 5–7 minutes. Drain thoroughly and allow them to cool. Once cool enough to handle, squeeze the cauliflower using a clean towel or paper towels to remove as much moisture as possible. This prevents a watery casserole. Transfer the dried cauliflower to a greased 9×13-inch baking dish.

Cook the Meat

In a large skillet over medium-high heat, cook the Italian sausage and chopped onion, breaking the meat apart as it browns. Once fully cooked, add the minced garlic and sauté for another minute until fragrant. Drain any excess grease before continuing.

Combine the Base

To the skillet, add the pizza sauce, half of the pepperoni slices, mozzarella cheese, Parmesan cheese, oregano, and red pepper flakes. Stir well to combine, creating a thick, flavorful meat mixture.

Assemble the Casserole

Pour the meat and sauce mixture over the cauliflower in the baking dish. Gently mix to ensure even distribution and smooth the mixture into an even layer.

Top and Bake

Sprinkle the remaining mozzarella cheese over the top. Arrange the remaining pepperoni slices evenly across the surface. Bake for 20–25 minutes, or until the casserole is bubbly and the cheese is melted and beginning to turn golden.

Serve

Allow the casserole to cool for 5–10 minutes before serving. This helps the dish set and makes it easier to slice. Add fresh basil or parsley on top for added flavor and color.

Important Tips for Success

Removing moisture from the cauliflower is essential. If the cauliflower remains wet, the casserole will become soupy. Always squeeze thoroughly until no excess water drips out.

This recipe is incredibly versatile. You can add vegetables such as mushrooms, bell peppers, olives, spinach, jalapeños, or onions. If using watery vegetables like mushrooms or bell peppers, sauté them first. You can also change the proteins by substituting ground beef, turkey, cooked chicken, or bacon. Cheese lovers may incorporate cream cheese or use a blend of mozzarella, provolone, or Italian cheeses. For a strict keto version, ensure that the sauce and processed meats are sugar-free.

This casserole reheats beautifully, making it perfect for meal prep. Store individual portions in airtight containers for quick and satisfying lunches throughout the week.

Easy Variations to Try

Meat Lover’s Version

Use a combination of Italian sausage, ground beef, pepperoni, and crumbled bacon. This creates a hearty, protein-rich option.

Chicken Alfredo Pizza Casserole

Replace the pizza sauce with 1½ cups of Alfredo sauce. Use 2 cups of cooked, shredded chicken instead of sausage. Top with mozzarella and Parmesan for a creamy, indulgent twist.

Egg-Based Crustless Version

Skip the cauliflower entirely and create a breakfast-style pizza casserole. Whisk 6–8 eggs with salt and pepper. Pour the eggs into a greased baking dish and layer the cooked meat, sauce, cheese, and toppings on top. Bake as usual. The eggs form a firm, sliceable base.

Zucchini or Eggplant Base

Use 4–5 medium zucchini or 1 large eggplant. Dice, salt, and let them sit for 20 minutes to draw out moisture, then rinse, pat dry, and sauté briefly before assembling.

FAQ

Can I use frozen cauliflower instead of fresh?
Yes, but be sure to cook and drain it well. Frozen cauliflower retains more moisture, so squeeze thoroughly.

Can I make this dairy-free?
You can use dairy-free mozzarella and Parmesan substitutes. Choose a dairy-free sauce as well to keep the dish compliant.

Is this recipe keto-friendly?
Yes, as long as the pizza sauce, sausage, and pepperoni contain no added sugars. Most major brands offer sugar-free versions.

Can I freeze this casserole?
You can freeze it before or after baking. For best texture, freeze before baking, thaw overnight, and bake as directed.

Can I add more vegetables?
Absolutely. Just ensure high-moisture vegetables are cooked first to avoid adding extra liquid.

Conclusion

Low-Carb Pizza Casserole delivers all the irresistible flavors of pizza without the carbs, making it perfect for those following low-carb or keto lifestyles. Its customizable nature, bold savory flavors, and satisfying textures make it a weeknight hero and an excellent meal-prep option. With endless topping variations and a reliable, easy method, this casserole guarantees a delicious, guilt-free pizza night anytime.