Italian Sausage Casserole is a spicy, cheesy combination of slices of hot Italian sausage, riced cauliflower, and a blend of cheeses. It’s a low carb, keto friendly, gluten free meal that’s easy to make and super tasty!
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Casseroles have been one of my go-to recipes while following a keto diet. They are just so easy to throw together and I love that I can prep it ahead of time to bake later.
My recipe for Buffalo Chicken Cauliflower Casserole is one of my top 5 recipes and one that I make regularly for dinner. I wanted to come up with another recipe with a similar combination of cheesy, spicy deliciousness.
I have also been looking for more spicy sausage recipes beyond sausage and peppers. This keto sausage casserole is the perfect answer and I haven’t come across anything like it before.
This recipe is similar to the Buffalo Chicken Cauliflower Casserole in that it is spicy and uses cauliflower rice with a combination of cheddar and cream cheese. The biggest differences are that it’s made with hot Italian sausage and red peppers.
If you’d like to try another low carb dish made with sausage, you may like this Keto Jambalaya.
Why This Recipe Works
I think the best thing about this recipe is that it’s different. While I love a good cheesy chicken or ground beef casserole, using sausage is less common but equally as delicious.
It’s an easy recipe to make and you can make it family friendly by using mild Italian sausage instead of hot.
From start to finish, it does take about an hour to prepare and bake. You can make it ahead of time up to the point of baking it and either place it in the refrigerator to finish later or freeze it for another day.
This recipe is low carb, keto friendly, and gluten free. It’s a high fat, moderate protein, low carb meal. There are just 8 grams of net carbs per serving.
How to Make Italian Sausage Casserole
What You Need To Make This Recipe
To make this recipe you will need:
- 1 tablespoon extra virgin olive oil
- 1 red pepper (diced)
- 1.5 pounds hot Italian sausage (cut into 1/2-inch slices)
- 8 ounces cream cheese (cut into 8 cubes – for faster melting)
- 5 cups cauliflower rice (here is tutorial on how to rice cauliflower, if needed)
- 8 ounces sharp cheddar cheese (shredded from a block)
- fresh parsley (minced, optional garnish)
The entire recipe and instructions can also be found in the recipe card at the bottom of this post. You can also print the recipe from the card, if needed.
What Is Italian Sausage?
Italian sausage is a pork sausage. It’s seasoned primarily with fennel and can be found in both mild and hot (spicy) varieties.
Prep!
There is a little bit of prep work for this recipe.
You will need to slice the sausage into 1/2-inch rounds, rice the cauliflower, shred the cheese, and dice the pepper. If you are planning to garnish the dish with fresh parsley, you will need to mince that, as well.
Create!
Preheat your oven to 375°F.
Add the olive oil to a large skillet over medium-high heat.
Once hot, add the diced red pepper and cook until it begins to soften and blister, about 5 minutes.
Add the Italian sausage to the pan and cook until it’s no longer pink in the center, about 10 minutes.
Tip: you can use ground Italian sausage, if preferred. It will cook slightly faster than the sliced links.
Drain off the excess grease. Try to get as much of the grease out as possible.
Place the cubes of cream cheese in a large bowl and pour the hot sausage mixture over them. Allow to sit a minute or so to soften the cheese, then stir.
Gradually mix in the cauliflower rice and half of the cheddar cheese until everything is well blended.
Spread into a large casserole dish and top with the remaining cheddar cheese.
Cover with foil and bake for 25 minutes. Remove the foil and bake an additional 10 minutes or until the cheese is hot and bubbly.
Present!
Garnish with fresh, minced parsley, if desired.
Tips and Techniques
- You can use mild Italian sausage, if preferred.
- You can use ground Italian sausage, if preferred. The cook time will be slightly less.
- Shred the cheddar cheese from a block for the best melting and texture. Pre-shredded bagged cheese has added starch which makes it grainy when melted.
- Store leftovers in an airtight container in the refrigerator. Use within 3-4 days.
FAQ’s
Can You Freeze Italian Sausage Casserole?
Yes. You can freeze Italian Sausage Casserole. Prepare the casserole up to the point of needing to bake it in the oven. Wrap tightly in aluminum foil and place in the freezer.
Thaw overnight in the refrigerator before baking. You may need to bake it 5-10 minutes longer to thoroughly heat it through.
What Is Italian Sausage Made Of?
Italian sausage is made from pork, pork fat, fennel or anise, spices and seasonings, and red pepper flakes or cayenne pepper, if it’s hot Italian sausage.
The spices and seasonings can vary, but may include a combination of any of the following:
- onion powder
- garlic powder
- parsley
- oregano
- thyme
- paprika
- smoked paprika
- sugar
- brown sugar
- salt
- pepper
More Low Carb Casserole Recipes To Try
- Ranch Bacon Chicken Casserole
- Cheesy Chicken Casserole with Cauliflower Rice
- Low Carb Jalapeno Popper Chicken Casserole
- Keto Breakfast Casserole with Bacon, Cauliflower, and Cheese
- Keto Broccoli Casserole
- Keto Green Bean Casserole
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Italian Sausage Casserole
Ingredients
- 1 tablespoon extra virgin olive oil
- 1 red pepper * diced
- 1.5 pounds hot Italian sausage * cut into 1/2-inch rounds
- 8 ounces cream cheese * cut into 8 cubes
- 5 cups cauliflower rice * from one large head of cauliflower
- 8 ounces sharp cheddar cheese * shredded
- fresh parsley * minced, optional
Instructions
- Preheat oven to 375°F.
- Add the olive oil to a large skillet over medium-high heat.
- Once hot, add the diced red pepper and cook until it begins to soften and blister, about 5 minutes.
- Add the Italian sausage to the pan and cook until it's no longer pink in the center, about 10 minutes.
- Drain off excess grease.
- Place the cubes of cream cheese in a large bowl and pour the hot sausage mixture over them. Allow to sit a minute or so to soften the cheese, then stir.
- Gradually stir in the cauliflower rice and half of the cheddar cheese until everything is well blended.
- Spread into a large casserole dish and top with the remaining cheddar cheese.
- Cover with foil and bake for 25 minutes. Remove the foil and bake an additional 10 minutes or until the cheese is hot and bubbly.
- Garnish with fresh, minced parsley, if desired.
Notes
Tips and Techniques
- You can use mild Italian sausage, if preferred.
- You can use ground Italian sausage, if preferred. The cook time will be slightly less.
- Shred the cheddar cheese from a block for the best melting and texture. Pre-shredded bagged cheese has added starch which makes it grainy when melted.
- Store leftovers in an airtight container in the refrigerator. Use within 3-4 days.
Rebecca Williams says
I cooked this casserole for the specified time and the cauliflower was still very crunchy. I’m in the process of cooking it for 15 minutes longer so see if that helps.
Linda L Stradley says
I made this tonight, with a few modifications based on what I had available.
I had a few mushrooms to use up, so sliced them up and sautéed them with the diced red bell pepper. Then I added a drained bag of Shirataki noodles, cut up into bite-sized lengths.
I heated that all together, then dumped them onto of the brick of cream cheese in my large Pyrex mixing bowl.
Then I browned the ground mild Italian sausage by itself in the pan. When it was fully browned and crumbled, I dumped it into the bowl with the other ingredients and blended the cream cheese, now melted to a mixing consistency, through it.
Adding the4 oz. of grated sharp cheddar cheese, I mixed it thoroughly, then spooned it into my casserole pan, topped it with the other 4 oz. of grated cheddar cheese, sprinkled the fresh chopped parsley on top.
Baked it for the 25 minutes and, OMG…It was SOOOOO good!!!!
It’s DEFINITELY on my “Make this again!” list!!!
Bella says
I loved this! I happened to have some Hot Ground Turkey Sausage on hand. I was looking for something to use it with and came upon your recipe. I didn’t have cauliflower rice but I did have frozen flaurets so I par microwaved them and hand chopped as small as I could. I actually used my air fryer for everything else, starting with the red peppers, then ground sausage in an air fryer barrel. Added everything else after sausage was done and cooked at 350. Then removed aluminum and cooked for 8 more mins. Fabulous! Thank you!
Emily Lewis says
I’m wondering if I can substitute brown minute rice for the cauliflower rice?
Lauren Vavala Harris says
Hi Emily,
Sorry, I don’t have any experience cooking with brown minute rice – hopefully someone else who uses it can respond to your comment to help out.
– Lauren
Janessa says
Hi! I am looking at the Serving Size and it says 1g? Was this a mistake? Could you tell me how many grams per serving size we can have?
Lauren Vavala says
Hi Janessa. Sorry about this. I think this happened with an update to the recipe card I use. The recipe servings isn’t broken down by weight since I work in my home (this is typically done in a food science lab). To get the estimated nutritional value per serving, you would divide the casserole into equal portions, in this case 6 portions.
I hope this makes sense,
Lauren
Renee says
Thank you for this! I’m looking to try it, but curious if a 12 oz bag of frozen riced cauliflower is enough?
Thank you for your help!
Lauren Vavala says
Hi Renee,
I think you’re only going to have around half of what you need for cauliflower rice if you only use a 12 ounce bag. That’s probably around 1 1/2 cups? You can also try cutting the rest of the recipe in half and make a smaller casserole (depending on how many servings you need).
Hope this helps a little,
Lauren
Renee says
Sounds good! Thank you for taking the time to reply!
Tina says
12oz is 4 cups according to the serving chart on my bag.
Katherine says
My family loved the recipe. It is easy to make and flavorful. Although making the cauliflower rice was a bit messy, I now know how to create the rice myself. I am adding this recipe to my favorites and will share it with some friends.
Beth says
Instead of fresh cauliflower rice, can you substitute frozen for this? Cook as directed and then drain?
Lauren Vavala says
I haven’t used frozen, but I’ve had many other people comment on other similar casseroles that it’s worked out just fine, so I would assume it will be ok for this one too 🙂
Lauren
Sarah Watson says
I used frozen cauliflower rice the first time I made this. I undercooked it in the microwave so it was all thawed but not hot or mushy. Stirred it in as directed and it was perfect. I am using fresh this time and it takes forever to cut up and will likely have more chew than the frozen… Can’t say yet if that’s better but I know the frozen was delicious
Lauren Vavala says
Hi Sarah! Yes, cutting the cauliflower does take forever. We have been displaced from our home without small appliances since January (long story!), and I refuse to rice cauliflower by hand haha! It will likely be more firmer, but that all depends on how small you chop it and long you cook it. I simply don’t like using frozen cauliflower, but thank you so much for the feedback. It’s definitely helpful to know it works out okay for those who prefer to use it.
– Lauren
Cathleen says
Ooh, I have GOT to try making this! I love a good casserole recipe and this one looks like a winner! Thanks 🙂
Geoffrey at Spoonabilities says
That looks SOOO GOOD. I can’t wait to make this recipe. Love Italian sausage on my pizza, and sausage and peppers, so this is an easy jump.
Jacquelyn says
I am in love with this casserole! It packed just the right amount of heat and the perfect blend of cheeses. I will be making this again very soon.
Anita says
This is a big hit with my picky eaters. I love sneaking in cauliflower rice into the casserole. 🙂
Alexandra says
Love the use of the cauliflower rice in this. Such a full of flavour meal for the whole family to enjoy!