Skip to Content

Low Carb Pizza Casserole

Disclosure: This post may contain affiliate links. I receive a small commission at no cost to you when you make a purchase using my link.

Low carb pizza casserole is here to save the day! It’s keto-friendly and loaded with veggies. Kids love the cheesy pepperoni pizza flavor, and moms love that it’s healthy!

You’d never know it’s one of those low carb casseroles. This is a favorite at our house, we make it often and switch up the toppings. Give this a try the next time you’re craving pizza without the guilt!

Let’s talk about my favorite low carb spaghetti squash recipe!

Cheesy Low Carb Pizza Casserole

Behold, the insanely popular Cheesy Low Carb Pizza Casserole. This recipe has totally been blowing up on Pinterest ever since I posted it a few years back.

Low carb casseroles have been a staple in our house for a long time because they are delicious and easy to make.

And THIS is the king of low carb casseroles.

Since being diagnosed with type 2 diabetes (after a long battle with PCOS and Insulin Resistance) I decided I had to take drastic measures and adapt a low carb lifestyle.

So far, it’s working pretty splendidly, the only problem is I often have to find low-carb replacements for my favorite comfort foods. Coming from a family that is part Italian, this means working out ways to get dishes that are similar to the carb-laiden pasta favorites.

So is it low carb pizza or low carb spaghetti?

It’s both! This dish has all the delicious taste of a low carb pizza without the crust, but it’s also got the fork-twirling feel of pasta without the carbs.

One of the things we’ve come to enjoy is spaghetti squash (also known in some circles as “winter squash). This funny vegetable can be cooked, and then shredded with a fork into long, low carb spaghetti-like strands.

The texture is similar to al-dente pasta, and it can be used in almost any recipe as a pasta replacement.

Tonight I had a craving for baked ziti, which I often used to top with pepperoni–much to the dismay of my more authentic Italian friends and family.

I have been doing good with veering away from carbohydrates, so I wanted to make sure I didn’t mess things up by eating a big bowl of pasta.

Enter my friend, Mr. Spaghetti Squash.

Using this great gourd, I was able to make a delicious low carb pasta “impasta” that filled us up, and kicked my craving to the curb!

Can I use zoodles instead of spaghetti squash?

If you aren’t loving spaghetti squash, or they aren’t in season (and therefore kinda spendy) you can also use “zoodles” which are simply zucchini cut with a vegetable spiralizer. I use the Veggetti and love it!

This Kitchen Active Spiralizer is nearly identical to the Veggetti, but cheaper!

It’s great with either vegetable. I haven’t tried it yet with other spiralized veggies, but you could try whatever your favorites are and experiment.

Is this a kid-friendly keto recipe?

You bet! I love this recipe because it’s delicious, but I know a lot of mom’s who appreciate it because their kids love the pizza part and totally don’t notice that they’re eating a bunch of healthy veggies!

You are getting a big ol’ serving of veggies in here. So give yourself a high five. Your kids may not even notice, and frankly, its ok not to tell them.

It can be our little secret.

Is this a diabetic-friendly recipe?

When we kept strict low carb, I lost over 60 pounds, my blood sugar stabilized and all my labs became nearly perfect. I definitely need to get back to that place, since we’ve veered a little off course.

We mostly do low carb (we don’t buy bread, pasta or cereal) but we have started to eat more things like potatoes than we used to and would like to get back to a more keto place for a while.

Anyway, if you eat a low carb diet or stick to a keto lifestyle, be sure to check out some of my other recipes below. Also, feel free to leave feedback on those recipes in the comments. Always looking for ways to improve them!

And of course, be sure to tell me below what you think of the cheesy low carb pizza casserole, and tell me if your kids loved it as much as I think they will!

More low carb and keto recipes you might like…

Be sure to check out these low carb recipe favorites too!

Check out my Low Carb Crock Pot Enchilada “Pasta”

Low Carb Mango Chicken

Low Carb “Fathead” Pizza Dippers

Low Carb Au Gratin Zucchini Casserole

Low Carb Chili Cheese Dog Casserole

and Low Carb Buffalo Shrimp Salad

these are just a few fantastic low carb meals!

Low Carb Pizza Casserole Recipe

Cheesy Low Carb Pizza Casserole

Cheesy Low Carb Pizza Casserole


  • Spaghetti Squash
  • 1-24oz jar spaghetti sauce or 24oz of homemade sauce (low sugar)
  • 1 cup shredded cheese divided in half
  • 1 tsp garlic powder
  • 1 tsp onion powder
  • Pizza toppings of your choosing:
  • Pepperoni
  • Sausage (precooked)
  • Green Peppers
  • Onions
  • Olives


  1. Preheat the oven to 350 degrees
  2. Pierce the squash all over with a sharp knife (CAREFULLY) 5-6 times
  3. Place on baking sheet and bake for 45 mins to 1 hr until it shreds easy.
  4. Remove from oven and carefully slice in half lengthwise
  5. Remove the seeds and stringy center section
  6. Shred with a fork, place in a medium mixing bowl
  7. Mix with 1/2 of the shredded cheese, garlic powder, onion powder and the jar of sauce (and any optional "toppings" that you want mixed in.
  8. Place in 9x9 baking dish and top with remaining cheese and any optional toppings.
  9. Place back in the oven and bake for 15-20 minutes until cheese is bubbly and toppings browned.
  10. Serve topped with Parmesan cheese and a side salad
how to make a budget baby shower basket
Baby Shower Basket Gift Idea
what to buy in march
What to Buy in March

99 Best Low Carb Dinner Recipe - Hike n Dip

Monday 1st of July 2019

[…] #21. Cheesy Low Carb Pizza Casserole¬† | Get the recipe here – […]


Monday 15th of May 2017

What are the macros for this


Monday 29th of July 2019

If you cut the spaghetti squash across in rings instead of lengthwise you get longer "noodles" more spaghetti like and it's easier to clean the seeds out! Win/win


Tuesday 28th of June 2016

Hi, so I tried this for dinner tonight. I poked holes in the squash and put it in the oven for hour. It wasn't done, so I put it in until it was soft and it came apart like spaghetti. I followed the directions.but the squash was hard. I'm wondering if my squash wasn't ripe? I'm not sure, I've never used spaghetti squash before. I kept the "pizza" in the oven for over an hour but the "noodles"didn't get soft. The flavor was amazing, I will definitely try this again! My husband ate it with the hard squash and everything, it was very good. Just wondering what I may have done wrong, so when I try again, my squash is soft? Thanks, Christina

An Exercise in Frugality

Thursday 30th of June 2016

Hi Christina! Try cutting the squash in half (when its raw) lengthwise (from stem to bottom) and scoop out the seeds. Place each half open side down on a lined cookie sheet and roast at 400 degrees for 45 mins to an hour depending on the size of the squash. When its done the shell will be golden brown and should come apart easily. If you really want it soft, leave it in a little longer, it turns kind of translucent and soft/mushy like spaghetti. A little less time and it comes out tender but with a little "toothiness" like al dente pasta. Just depends on your preference. You can also cook it in a slow cooker 8 hours on low by dumping in your sauce first, then the two halves of squash open side down (seeds removed). Either way is fine. Cooking time will vary because the squashes vary GREATLY in size, so you might have to adjust but either way, I recommend cooking it cut in half first as it speeds up the process :) Hopefully that helps! Glad you liked the recipe!

Jo Bowman

Tuesday 9th of February 2016

My husband was diagnosed as type 2 last summer. It has really changed the way I do meal planning! Pasta has always been a go-to meal for us, with garlic bread, and maybe a salad. Pepperoni pizza is something we have not had since the diagnosis and I had been longing for one. We will try this with a salad (none of my beloved garlic bread) for dinner tomorrow night. It looks yummy.

Rose @An Exercise in Frugality

Tuesday 9th of February 2016

Thanks Jo! I didn't realize until being diagnosed just how much we rely on carbs (bread, starches, etc) in our diet! Cutting out pasta and bread is hard at first but you get used to it. We use spaghetti squash in place of pasta in all our favorite dishes now. Just last night we had chicken parm with spaghetti squash marinara! Its a little different, but its still tasty! I also do "zoodles" or zucchini noodles. Those are pretty good too as they take on the flavor of your sauce. Good luck with the new lifestyle and I hope you like the recipe!

15 Delicious Low Carb Recipes | My Crazy Good Life

Monday 25th of January 2016

[…] Cheesy Low Carb Pizza Casserole from An Exercise in […]