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slice of pizza casserole on a white plate

Low Carb Keto Pizza Casserole

If you're living the low carb life but missing pizza, this is the answer! Cauliflower crust, traditional pizza toppings, gooey cheese all in comforting casserole style!
Course Main Dish
Cuisine Italian
Prep Time 10 minutes
Cook Time 15 minutes
broiling time 5 minutes
Total Time 30 minutes
Servings 6
Calories 483kcal
Cost $5


  • 9 x 13 casserole dish
  • large skillet


  • Ingredients:

For the Crust:

  • Olive oil spray for coating the pan
  • 2 cups riced cauliflower fresh or frozen
  • 3 large eggs
  • ½ teaspoon salt
  • ½ teaspoon garlic powder
  • ½ teaspoon oregano
  • 1 cup mozzarella cheese shredded

For the filling

  • 1 pound Italian style sausage mild, medium, or hot.
  • ½ cup onion diced
  • ½ cup green peppers diced
  • 2 ounces pepperoni roughly chopped. Plus extra for topping left whole
  • 8 ounce jar pizza sauce
  • 1 cup mozzarella cheese shredded


  • Instructions:


  • Preheat the oven to 400°. Lightly coat a 9 x 13 inch dish with olive oil spray
  • Mix the cauliflower rice, eggs, garlic, salt, oregano, and one cup of the mozzarella cheese in a bowl.
  • Place the mixture in the 9 x 13 inch pan and spread evenly on the bottom.
  • Place in the oven, uncovered for 15-20 minutes.


  • While that’s baking, make the topping. Place a skillet over medium high heat, add the sausage and brown, breaking up with a spoon, until cooked through. Add the onions, peppers, and pepperoni and saute until the onions are translucent. Drain the excess fat, and return the mixture to the pan.
  • Add the pizza sauce and stir to combine.
  • When the crust is finished cooking, remove from the oven.
  • Spread the sausage mixture over the top of the crust.
  • Add the remaining cheese and pepperoni.
  • Place under the broiler for 2-4 minutes to melt and brown the cheese.


  • You can 'rice' your own cauliflower, use fresh store bought, or frozen. If using frozen, thaw and squeeze out excess moisture.
  • If you want an even tastier crust, you can roast the cauli rice in a 400° oven for 5-10 minutes. Adds a sweeter deeper flavor.
  • You can use egg whites in place of whole eggs to lighten it up. Just make sure you use 100% egg whites if you're purchasing the carton. 3 tablespoons of egg whites are equivalent to 1 large egg.
  • You can substitute 1 teaspoon of Italian seasoning for the garlic powder and oregano.
  • Turkey sausage and turkey pepperoni work great in this recipe.
  • Personally, I love the crust, but, you can skip it altogether and eat yourself a "meatza".
  • To make this ahead of time:
    1. Simply follow the instructions up to through the assembly.
    2. Instead of baking it then, cover well and place it in the refrigerator or freezer (depending on how soon you need it).
    3. To heat: If it's frozen, thaw in your refrigerator first. Then preheat the oven to 350°, bake loosely tented with foil for 20-25 minutes. Remove the foil and return it to the oven until the cheese is fully melted and bubbling.


Calories: 483kcal | Carbohydrates: 8g | Protein: 26g | Fat: 39g | Saturated Fat: 16g | Cholesterol: 179mg | Sodium: 1393mg | Potassium: 602mg | Fiber: 2g | Sugar: 4g | Vitamin A: 581IU | Vitamin C: 41mg | Calcium: 239mg | Iron: 2mg