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Sausage slices, spaghetti squash and peppers in cream sauce in a skillet.
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5 from 4 votes

Italian Sausage Spaghetti Squash Skillet

Italian Sausage Spaghetti Squash Skillet is a delicious dinner recipe that combines smoked or Italian sausage, sweet bell peppers, onions and savory squash all into one creamy sauce. It’s a family-friendly recipe that is suitable for a variety of diets including low carb and gluten free.
Prep Time15 minutes
Cook Time45 minutes
Total Time1 hour
Course: Main Dish
Cuisine: American, Beef, Gluten Free, Low Carb, Pork
Diet: Gluten Free
Servings: 6 servings
Calories: 561kcal

Ingredients

Roasted Spaghetti Squash

Sausage Spaghetti Squash Skillet

  • 1 1/2 pounds sausage (cut into 1/2 thick rounds or slices)
  • 2 red bell peppers (diced)
  • 1 onion (diced)
  • 4 cloves garlic (minced)
  • 1 tablespoon Italian seasoning
  • 2 tablespoons tomato paste
  • 1 cup heavy cream
  • 1/3 cup Parmesan cheese
  • fresh parsley (optional)

Instructions

Roasted Spaghetti Squash

  • Preheat your oven to 350°F.
  • Cut the squash in half length-wise and remove the seeds. Place on a sheet pan. Drizzle with olive oil and season with salt and pepper.
    1 medium spaghetti squash, 1 tablespoon extra virgin olive oil, salt, pepper
  • Roast at 350°F for 45-60 minutes or until tender.
  • Use a fork to scrape out strands of squash that resemble spaghetti.

Sausage Spaghetti Squash Skillet

  • While the squash is roasting, heat a large skillet over medium and add the sausage. Cook until heated through and browned to your liking, about 5-10 minutes.
    1 1/2 pounds sausage
  • Remove to a plate and tent with aluminum foil to keep warm.
  • There may be enough oil from the sausage left in the pan, but if not add a drizzle of olive oil and the diced peppers and onion. Season with just a pinch of salt and pepper.
    2 red bell peppers, 1 onion
  • Cook, stirring often, for 3-5 minutes or until softened.
  • Stir in the garlic and cook an additional 30 seconds.
    4 cloves garlic
  • Add the Italian seasoning, tomato paste and heavy cream to the skillet and stir to blend well. Raise the heat and cook 1-2 minutes or until the cream is hot and bubbly, stirring often.
    1 tablespoon Italian seasoning, 2 tablespoons tomato paste, 1 cup heavy cream
  • Turn off the heat and stir in the Parmesan cheese until melted and well combined.
    1/3 cup Parmesan cheese
  • Add the sausage back to the skillet, along with the spaghetti squash. Toss to coat evenly. Taste and season with salt and pepper if needed. 
  • Garnish with fresh parsley, if desired.
    fresh parsley

Notes

Tips and Techniques

  • To save time, you can cook the spaghetti squash ahead of time and reheat it when needed.
  • You can cook the spaghetti squash in the microwave to save time, if preferred. Simply pierce the squash into the center several times. Place on a microwave-safe plate. Cook on high for about 8-12 minutes, or until the squash is tender. Once the squash is cool enough to handle, cut it in half length-wise, remove the seeds and scrape out the strands with a fork.
  • You can add crushed red pepper for a spicier dish or mix in spinach or kale for even more vegetables.
  • Store leftovers in an airtight container in the refrigerator. Consume within 3 to 5 days.
** Nutritional information is an estimate and may vary.

Nutrition

Serving: 1serving | Calories: 561kcal | Carbohydrates: 13g | Protein: 18g | Fat: 49g | Saturated Fat: 21g | Polyunsaturated Fat: 4g | Monounsaturated Fat: 20g | Cholesterol: 129mg | Sodium: 1115mg | Potassium: 492mg | Fiber: 2g | Sugar: 6g | Vitamin A: 2022IU | Vitamin C: 55mg | Calcium: 137mg | Iron: 2mg