Paleo Pizza Casserole

best pizza casserole recipe

It’s time to bring Pizza Night back! Grain-free and Dairy-free style :-)

There’s a popular recipe for pizza casserole (maybe you’ve tried it) that combines spaghetti noodles, pizza toppings, and cheese to create a very tasty, very kid-friendly dinner.

The problem with this traditional recipe for pizza casserole is that it’s lacking in nutrition while bursting with fat-inducing calories. And though the kids may take a few bites, Mommy and Daddy end up eating all the leftovers…and hating themselves for it the next day. Not cool. So I created this Pizza Casserole that you can polish off and still feel great. I’ll show you how simple this dish is to make in the video below…

In place of the spaghetti noodles, I call for making noodles out of butternut squash (or sweet potato for heartier noodles) using a spiral slicer. The reason for using sweet potato or butternut squash, rather than zucchini, is that theses noodles are firmer and will become tender with the baking time, whereas zucchini noodles would get soggy and most likely break apart. Note: Butternut squash noodles hold more moisture that turns into liquid while cooking, so you’ll want to drain off most of this liquid after the cooking time. There won’t be extra liquid when using sweet potato noodles. (I used butternut squash noodles in the video and sweet potato noodles in the photo.)

Paleo Pizza Casserole
A Recipe by Diana Keuilian
5.0 from 2 reviews

Prep time
Cook time
Total time
Serves 10

  • 2 teaspoons extra virgin olive oil plus more for greasing the pan
  • 5 small sweet potatoes (or butternut squash)
  • Sea salt and black pepper, to taste
  • 1 teaspoon minced garlic (about 1 clove)
  • 1 yellow onion, chopped
  • 1 bell pepper, seeded and chopped
  • 1 pound loose sweet pork sausage
  • 1 (2.25-ounce) can olives, sliced
  • 2-4 vine-ripened tomatoes, diced (optional)
  • 1 (16-ounce) jar tomato basil pasta sauce
  • 30 nitrate and sugar-free pepperoni slices, halved
  • ¼ cup fresh basil, chopped and then measured

  1. Preheat the oven to 425 degrees. Lightly grease a 10” x 15” glass casserole pan with olive oil.
  2. Peel the sweet potatoes (or butternut squash) and trim them to a size appropriate for your spiral slicer. Run all of the pieces through the slicer to create long, spaghetti-like noodles. Place the noodles in the prepared pan and toss with sea salt and black pepper.
  3. Place a large skillet over medium-high heat. Add the olive oil and garlic and sauté for 3 minutes. Add the onion and sauté until translucent, about 8 minutes. Add the bell pepper and pork sausage and cook, breaking up the sausage into small pieces with your spoon or spatula, until all of the pink is gone. Drain the fat from the skillet.
  4. Stir in the olives, tomatoes if using them, pasta sauce, pepperoni slices, and basil. Cook for another 3 minutes, then pour the tomato mixture over the pan of noodles. Cover the pan tightly with foil and bake for 25 minutes or until the noodles are tender.

Calories: 297     Fat: 17     Carbohydrates: 13     Sugar: 6     Sodium: 966     Fiber: 4     Protein: 15    

Quick Tip: Choose nitrate and sugar-free pepperoni slices for this dish. Or, if you’re not a fan of pepperoni, then feel free to leave it out completely. You could also get creative with the ground meat – use whatever kind you prefer, and vary it from time to time.

best pizza casserole recipe

I love having a scoop of leftover pizza casserole over a bed of greens for a quick and tasty lunch!


  • Peggy J Miller April 8, 2016 at 6:47 pm

    I filled out the comment area above. IT is delicious!!!!! Thanks!

  • Candice May 25, 2016 at 9:22 pm

    My 8 year old son loves this! Little did he know he was eating healthy! Can’t wait to make our “pizza night” a pizza casserole night! Thanks for the great recipes! Keep it up!

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