
This gooey cheese-topped low-carb pizza bake brings all the classic pizza taste you crave without the carb count. Every forkful delivers that magic mix of zesty Italian sausage, crisp pepperoni, and veggies wrapped in melty cheese that'll win over devoted pizza fans while staying totally keto-friendly.
I whipped this up during my first few weeks of cutting carbs when I was dying for pizza. These days my hubby asks for it every week and swears it beats takeout pizza because he can eat more without feeling sluggish afterward.
Ingredients
- Italian sausage: Makes up the main protein punch; go for loose sausage or squeeze meat from links for quicker cooking
- Cauliflower: Steps in for normal crust or pasta, adding bulk while keeping carbs super low
- Mushrooms: Give a meaty, rich taste and substantial bite; cut them the same size so they cook evenly
- Green pepper: Adds fresh snap and that pizza joint flavor; chop into similar sized pieces
- Low carb pasta sauce: Brings that tomato kick without added sugar; try Raos brand with just 4g carbs per serving
- Mozzarella cheese: Creates those iconic stretchy strands; grate it yourself for smoother melting
- Pepperoni: Gives that authentic pizza taste and crunch; try to find uncured ones with fewer additives
- Parmesan: Brings a salty depth; freshly grated tastes way better
- Italian seasoning: Adds those key herb flavors; make sure yours smells strong and isn't stale
How To Make Low Carb Pizza Casserole
- Get the cauliflower ready:
- Pop cauliflower chunks with water in the microwave for exactly 3 minutes until they're soft but still a bit firm. This quick method keeps their texture while making sure they won't make your casserole soggy. After cooking, pat them really dry to keep extra water out.
- Cook the sausage:
- Fry Italian sausage on medium-high heat, breaking it into tiny bits as it cooks. This takes around 15 minutes to get that tasty browning that adds so much flavor. Drain off the fat completely or your dish might turn out greasy.
- Cook the mushrooms:
- Sauté sliced mushrooms in olive oil for a full 10 minutes so they release their water and then soak it back up. This makes them extra flavorful and stops them from making your casserole wet. Look for golden edges which show they're done right.
- Build your casserole:
- Start with a thin sauce layer, then stack meat, veggie mix, sauce, cheese and pepperoni in turns. Press each layer down gently but don't squish it too much. Scatter pepperoni throughout so everyone gets some in their serving.
- Add the top layer:
- Mix Parmesan with Italian herbs for the top sprinkle which will form a tasty crust while baking. Save some pepperoni for the very top where they'll get extra crispy, giving your dish different textures.
- Bake it up:
- Cook at 400°F for 30 minutes until it's bubbling around the edges and the cheese has brown spots. Let it sit for 5 minutes before you cut it so it holds together better and won't burn your mouth.

The star ingredient for me has to be the Italian sausage that takes me back to the pizza place down the street from where I grew up. The first time I made this for my Italian grandma, she wanted the recipe - probably the best kitchen compliment I've ever gotten.
Make Ahead and Storage
This dish works wonders for planning ahead. You can put the whole thing together up to a day before cooking - just wrap it tight with plastic and stick it in the fridge. When you're ready to cook, take it out about 30 minutes early so it can warm up a bit. This helps it cook all the way through.
Any leftovers keep well in sealed containers in the fridge for up to 4 days. To warm up single servings, pop them in the microwave for 2 minutes until they're hot. If you want the top crispy again, heat it in a 350°F oven for 15 minutes. The taste actually gets better after a day as all the flavors mix together more.

Customize Your Casserole
Think of this dish as your pizza playground. Got a thing for olives? Throw in some sliced black ones between layers. Want some kick? Add crushed red pepper or some jalapeño slices. For a loaded version, mix in diced onions and Canadian bacon.
If you can't do dairy, you can swap in non-dairy cheeses, though they won't get as melty as real mozzarella. Watching calories more than carbs? Try turkey Italian sausage and reduced-fat mozzarella for a lighter take that's still packed with flavor.
Serving Suggestions
This dish works great by itself, but try pairing it with a basic green salad with olive oil and lemon for a full meal. The fresh salad balances out the rich, cheesy bake.
If you're not strictly counting carbs, some garlic bread on the side works great. Sticking to keto? Serve it with some roasted broccoli or zucchini noodles tossed in olive oil and garlic.
This casserole makes a fantastic dish to bring to gatherings since it travels well and tastes good even at room temp. Just make sure to mark it as gluten-free and low carb for folks with food restrictions.
Frequently Asked Questions
- → Can I swap out the vegetables?
Of course! Try zucchini, spinach, or even bell peppers depending on your preference or what you’ve got on hand.
- → Which low-carb sauce is best?
Go for a low-carb marinara like Rao's Homemade to keep it flavorful and light on carbs.
- → What if I want it spicy?
Kick up the heat with some red chili flakes, diced jalapeños, or spicy Italian sausage.
- → Can I prep this beforehand?
Definitely! Assemble it a day ahead, keep it in the fridge, and bake when ready for an easy meal.
- → How can I make it dairy-free?
Switch out the mozzarella and Parmesan for plant-based cheese and pick a sausage without dairy.
- → What’s the best way to reheat leftovers?
Warm individual servings in a microwave or reheat the entire dish at 350°F in the oven.
- → Can I freeze it?
Absolutely! Assemble it pre-baking for freezing, or store baked leftovers for up to two months in the freezer.