This keto pizza casserole has all the best parts of a pizza baked together, creating the ultimate low-carb comfort food. Cheesy, meaty, and made with just five ingredients, it takes only 20 minutes to make.

Keto Pizza Casserole

This may surprise some, but we order a fair share of pizza delivery in my house. Even when I’m eating keto, that doesn’t mean I want to forgo one of our favorite weekend treats.

Que, keto pizza, pizza bowls, and, more recently, keto pizza casserole. Rather than piling our toppings on a keto pizza crust, everything is layered on a bed of low-carb pasta and baked until the cheese is bubbly and golden brown.

It’s one of my favorite dishes to make when we’re hosting since it’s full of delicious flavors everyone will love, yet it’s deceptively low in carbs.

Table of Contents

• Recipe Highlights
• Ingredients Needed
• How to Make a Keto Pizza Casserole
• Recipe Tips and Variations
• How to Store Leftovers
• Frequently Asked Questions
• More Keto Casserole Recipes to Try
• Keto Pizza Casserole (Recipe Card)

Recipe Highlights

• No Cauliflower Needed – As much as I love cauliflower pizza crust, sometimes I need a break from cauliflower.
• Easy to Customize – I provide the base recipe, but you can get creative and layer on your favorite pizza toppings, just like traditional pizza.
• Always a Crowd-Pleaser – Adults and kids alike always rave when I make this pizza casserole. Even your friends who aren’t on a keto diet will beg you for the recipe.
• Ready in 30 Minutes – Like crustless pizza and chicken crust pizza, this casserole makes for an easy and fast weeknight dinner.

Ingredients Needed

If you’ve made any of my other keto dinner recipes before, you’ve probably already got everything on hand. If not, you can find them all at your local grocery store. Here’s what you’ll need:

• Keto Pasta – I used gluten-free rotini pasta, which holds sauce and cheese better than other kinds. Any keto pasta works, even homemade almond flour pasta.
• Onion and Garlic – Adds extra flavor to the sauce mixture.
• Ground Sausage – A must for any good pizza-inspired dish. You can use any ground beef or pork if you can’t find ground sausage.
• Pizza Sauce – Homemade keto pizza sauce, not store-bought ones that are full of sugar and unnecessary carbs. You can also use pomodoro sauce or sugo, two homemade Italian tomato sauces with very few carbs.
• Parmesan and Mozzarella Cheese – A combination of both yields stretchy and melted cheese.
• Pepperoni – A simple and classic pizza topping.

How to Make a Keto Pizza Casserole

I’ve included step-by-step photos below to make this recipe easy to follow at home. For the full printable recipe instructions and ingredient quantities, scroll to the recipe card at the bottom of this post.

1. Cook the Pasta – Start by cooking the pasta as per the package directions until al dente. Drain and set aside.
2. Make the Filling – Heat some olive oil in a large pot over medium heat. Add the onion and garlic, cooking until fragrant. Add the ground sausage and cook until no longer brown. Stir in the pizza sauce and simmer for 4-5 minutes. Remove from heat and mix in the cooked pasta and parmesan cheese.
3. Bake the Casserole – Transfer the pasta mixture into a greased 8 x 13-inch baking dish. Sprinkle the remaining parmesan cheese, then the mozzarella cheese. Place the pepperoni on top and bake for 20-25 minutes or until the cheese has melted. Remove from the oven, cut into pieces, and serve immediately.

Serving Suggestions

While this dish is delicious on its own, there are tons of low-carb side dishes that pair well with it. Some classic options include keto garlic bread, keto cheese bread, and keto bread varieties like keto rolls and keto buns.

Try a keto potato salad, cauliflower potato salad, or coleslaw for some greens or vegetables.

Recipe Tips and Variations

• Lower the Carbs – Use half the pasta and double up on the sauce.
• Add More Protein – For a heartier casserole, add shredded chicken, bacon, or diced ham.
• Add More Low-Carb Veggies – Sliced green bell peppers, mushrooms, diced tomatoes, black olives, or spinach.
• Garnish – Fresh basil adds a bright flavor and pop of color.
• Make It Spicy – Add a few dashes of red pepper flakes to the sauce.
• Make a Creamy Red Sauce – Fold in ½ cup of cream cheese for a more decadent sauce.

How to Store Leftovers

• To Store: Leftovers can be stored in the refrigerator, covered, for up to five days.
• To Freeze: Place the cooked and cooled casserole in a large container and store in the freezer for up to six months.
• Reheating: Microwave portions for 30-40 seconds until hot or reheat in a preheated oven.

Make-Ahead Tip

If you’d like to make this casserole in advance, it can be prepped, stored, and covered in the fridge for up to three days. When you’re ready to bake, let it sit at room temperature for 15 minutes, then bake as directed.

Low Carb Pizza Casserole

Frequently Asked Questions

How Many Carbs Are in Pizza Casserole?

There are just 3 grams of net carbs in a serving of this pizza casserole.

Can I Make This Vegetarian?

For a vegetarian option, switch out the ground sausage for a plant-based alternative, like Beyond Meat crumbles.

This keto pizza casserole is a fantastic meal that’s easy to make, full of flavor, and perfect for anyone following a low-carb lifestyle.