clock clock iconcutlery cutlery iconflag flag iconfolder folder iconinstagram instagram iconpinterest pinterest iconfacebook facebook iconprint print iconsquares squares iconheart heart iconheart solid heart solid icon

Low Carb Spaghetti Squash Pizza Casserole (Paleo, Whole30, AIP, Keto)

  • Author: Michelle
  • Total Time: 50 minutes
  • Yield: 5 servings 1x


  • 1 cooked spaghetti squash, using the oven or instant pot 
  • 1 lb ground beef (or Italian sausage if tolerated)
  • 1/2 white onion, diced
  • 2 cloves garlic, minced
  • 1 cup mushrooms, sliced
  • 1 tsp sea salt
  • 1/2 tsp black pepper (omit for AIP)
  • Optional- 2 eggs (omit for AIP)
  • 1 cup sugar-free “tomato” sauce (use this for AIP, or a sugar-free sauce if you tolerate nightshades)

For toppings

  • 1/4 cup black olives, sliced
  • 1/4 cup red onion, diced
  • 1 tbsp fresh basil, chopped
  • 2 tsp fresh parsley, chopped


  1. Preheat the oven to 400 F and prepare an 8×8″ baking dish
  2. Using a large skillet on medium heat, brown the ground beef (or sausage) and lightly salt. Set aside, reserving some of the fat in the pan.
  3. Saute the white onion and garlic in the pan until lightly translucent. Add in the mushrooms and cook for 3-4 minutes or until soft.  Set aside.
  4. Take the cooked spaghetti squash and remove the strands with a fork and place in a large mixing bowl. Use a paper towel or clean cloth to pat down some (but not all) of the excess liquid.
  5. If using eggs, whisk the eggs together in a separate bowl, and mix with the squash, salt, and pepper.
  6. Mix the ground beef, cooked vegetables (reserving about 8-10 mushroom slices), and 3/4 cup of the sauce with the spaghetti squash. Pour into the casserole dish and evenly distribute.
  7. Top the casserole with the remainder of the sauce and mushrooms.
  8. Bake in the preheated oven for 30 minutes.
  9. Remove from the oven and top with extra toppings. Use a spatula to remove slices and enjoy!


All nutritional information are estimations and will vary. Nutritional information does not include optional ingredients.

  • Prep Time: 5
  • Cook Time: 45
  • Category: casserole
  • Method: oven
  • Cuisine: Italian


  • Serving Size: 1 serving
  • Calories: 196
  • Fat: 4.4g
  • Carbohydrates: 18.2g
  • Fiber: 4g
  • Protein: 22.5g

Keywords: pizza, casserole, paleo pizza