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Overhead of Italian Sausage Casserole with a scoop being lifted up with a wood turner in a white, square casserole dish over a wood board over a gray background with a blue and white towel on the bottom end
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5 from 5 votes

Italian Sausage Casserole

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!
Prep Time20 mins
Cook Time35 mins
Total Time55 mins
Course: Main Dish
Cuisine: American, Gluten Free, Italian, Low Carb
Servings: 6 servings
Calories: 734kcal


  • 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


  • 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.



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.
** Nutritional information is an estimate and may vary.


Serving: 1serving | Calories: 734kcal | Carbohydrates: 11g | Protein: 31g | Fat: 64g | Saturated Fat: 28g | Cholesterol: 167mg | Sodium: 1226mg | Potassium: 817mg | Fiber: 3g | Sugar: 5g | Vitamin A: 1507IU | Vitamin C: 92mg | Calcium: 359mg | Iron: 2mg