Gluten-free Spaghetti Squash and Sausage Casserole

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This Gluten-free Spaghetti Squash and Sausage Casserole is a delicious paleo and low-carb meal that is simple and tasty! Gluten-free, grain-free and full of flavor!

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First Published on March 22, 2015
Re-posted with updated photos

This one is yet another casserole (you know how fond of casseroles I am), and it was delicious! And low-carb too! It does contain cheese, so if you are sensitive to dairy or want a fully-paleo recipe, I would omit the cheese.  I can tolerate it in smaller doses, so I like to have it once in a while.  I do keep away from it for the most part, but every once in a while I do like to cook with some cheese.

Paleo Spaghetti Squash and Italian Sausage Casserole on a plate

This is probably one of my favorite casseroles to make.  This Paleo Spaghetti Squash and Italian sausage casserole is super tasty.  This is a great low-carb casserole that is a repeat in my household. I love making this recipe.

Serving of Gluten free spaghetti squash and sausage casserole

I really do love casseroles. To me, they seem to make life easier because they make for great leftovers! And this gluten free spaghetti squash and sausage casserole makes for excellent leftovers! I bring a serving into work for lunch and whenever I heat it up, my co-workers always comment on how good it smells!

Serving of Primal Spaghetti Squash and Italian Sausage casserole


Gluten-free Spaghetti Squash and Sausage Casserole
Prep Time
30 mins
Cook Time
30 mins
Total Time
1 hr
Course: Main Course
Keyword: paleo casserole, spaghetti squash and sausage casserole, spaghetti squash casserole
Servings: 8
  • 1 large spaghetti squash
  • 1 lb ground Italian sausage
  • 4 cloves garlic minced
  • 1 cup coconut milk
  • 1/2 tsp ground Sage
  • 1 tsp salt
  • 1/2 tsp black pepper
  • 2 large eggs whisked
  • 1/2 cup shredded mozzarella
  • 2 Tbsp grass-fed butter softened
  • 1 cup almond flour
  1. Heat the oven to 400 degrees. Cut your spaghetti squash in half lengthwise and scoop out the seeds. Brush it with a little bit of olive oil, and place it cut-side down on a baking sheet. Cook the spaghetti squash for 30-45 minutes, or until it is done and the insides are soft.

  2. When the spaghetti squash has cooled enough to handle it, scoop out the threads with a fork and place them into a 9x13 baking dish. Lower the over to 350 degrees.

  3. In a pan over medium-high heat, cook your sausage until it is done and there is no pink. When it is finished, remove the sausage (leave the fat in the pan) and set aside.
  4. Lower the heat and add the garlic to the pan. Stir for about a minute, until garlic is soft. Add the coconut milk and spices, and simmer for about 5 minutes, stirring frequently.

  5. Add the sausage and the sauce to the casserole dish, and mix everything together with a fork. Add the whisked egg to the mixture, and stir the mixture with the fork until the ingredients are well blended.
  6. Sprinkle the shredded mozzarella over the top of the entire dish (omit if you are dairy-sensitive).
  7. Combine the almond flour with the softened butter with a fork or pastry cutter until it is a crumbly mixture (you'll want to make sure the butter is only softened, and not melted.  If the mixture is too soft, you can refrigerate it until it becomes a little more solid). Sprinkle the crumbs over the top of the casserole.

  8. Place the casserole dish into the oven and bake for 20-30 minutes, until the crust is light brown. Let cool, then serve and enjoy!

paleo sausage and spaghetti squash casserole



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