Meatball Casserole
If you are looking for a new family dinner this homemade Meatball Casserole should be it. Juicy, flavorful meatballs baked until golden and then covered with tomato sauce and cheese. My low carb keto Meatball Casserole was a hit with my family and should be a hit with yours.

When I was in college, I was still a vegetarian. One of my favorite meals from the dining hall takeout was a vegetarian Italian meatball parmesan sub. I have no idea what those “meat”balls were made of, and I probably don’t want to know, but it was terrific.
It was smothered in tomato sauce and topped with provolone. I’d look forward to Tuesdays so I could get dining hall take-out and my favorite meatball parmesan sub. Almost fifteen years later, that is the only dining hall food I recall, and that is my inspiration for my cheesy meatball casserole.
This casserole with meatballs was a perfect substitute. I could eat this Italian meatball casserole recipe once a week for the rest of my life and never get sick of it. And my whole family would agree.
Love this? Try my Keto Chicken Parmesan next! Breaded with parmesan cheese, it is lighter than classic chicken parm but just as good!

Ingredients
- Ground Meat – I typically use ground turkey but ground beef, ground pork, or ground chicken work as well.
- Ground Sausage – I use sweet Italian sausage but hot Italian sausage is fine or a combination of the two.
- Egg – The egg is the binder in this in addition to the grated parmesan cheese.
- Shredded Zucchini – You can’t taste it and it gives a lot of moisture to the meatballs.
- Shredded Mozzarella Cheese – You can also use a blend of Italian cheese.
- Keto Marinara Sauce – I like to make my own but any pasta sauce or tomato sauce without added sugar is fine.
- Spices – I prefer to use dried onion, garlic, and basil in these. You can use Italian seasoning in place of the basil if you prefer the flavor of that.
- Salt & Pepper

How to Make a Meatball Casserole
Step One: Put all the ingredients for the meatballs in a large mixing bowl and mix. You can do this by hand or with a rubber spatula.

Step Two: Next, scoop the meatballs. A large cookie scoop makes this very easy. You should end up with 24 meatballs. Bake in a baking dish coated with cooking spray until they are almost completely cooked. I shoot for 150-155 on my meat thermometer.

Step Three: Top with sauce and sprinkle mozzarella cheese on top and finish baking. For the best golden brown cheese on top broil the low carb meatball casserole for 2-3 minutes, watching it carefully.
Top Tip💡
You can make the Italian meatballs ahead of time, cook until fully cooked, and then freeze the cooked meatballs in a freezer bag. Just place the frozen meatballs in the casserole dish, bake until thawed, and then top with the sauce and cheese. This easy prep idea is always a perfect meal on busy weeknights.
Storage
Store any leftovers in an airtight container in the fridge for 3-4 days.

Variations
- Fresh Basil – If you have fresh basil, feel free to mix some into the ground meat mixture, add some to the marinara, or sprinkle on top after baking.
- Spices – Swap the dried minced onion and garlic for onion powder and garlic powder, or sub in Italian seasoning.
This Sausage Parmigiana is also a great choice if you need more dinner recipes! Or for a vegetarian version sub in cauliflower and try my Cauliflower Parmesan.
Common Questions
We enjoy it with a side salad, vegetables, or any of the main low carb pasta options out there, such as palm noodles and zoodles.
Our family’s favorite ways to serve this is on top of zucchini noodles or spaghetti squash. For any non-keto eaters, you can serve with garlic bread or a side of al dente pasta.
Alternatively, you can serve with a side of roasted broccoli or green beans or a green salad.
Yup! Here the meatballs are after forming them. I use a large cookie scoop to simplify the process. Since there is no need to get up to your elbows in raw meat, this is a great task to get the kids involved in. Mine are pros at scooping low carb meatballs by now. Make sure to also check out the video below.
That hidden zucchini in my juicy meatballs is my sneaky mom favorite addition. My kids don’t even notice it’s in there. If you really want to hide it you can peel the green skin off first.
If you would like to substitute another veggie for the zucchini I would recommend chopped spinach.
Absolutely! This easy meatball recipe also freezes really well! Go ahead and make a double batch and then next time you want an easy Meatball Casserole just thaw, dump into the baking dish, and cover with sauce and cheese. Meatball Parmesan in a jiffy!
I love to always have a bag of low carb homemade meatballs in the freezer for nights that I don’t want to cook.

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Video

Meatball Casserole Recipe
Equipment
Ingredients
Meatball Ingredients
- 1 lb ground turkey
- 1 lb Italian sausage
- 1 cup shredded mozzarella
- 1/3 cup grated or shredded parmesan
- 1 medium shredded zucchini about 1 cup
- 1 egg
- 2 tsp dried minced onion
- 2 tsp dried minced garlic
- 2 tsp dried basil
- 1 tsp salt
Casserole Ingredients
- 1 cup marinara sauce
- 8 oz shredded cheese (I used a two cheese pizza blend of mozzarella and provolone)
Instructions
- Preheat oven to 400. Spray a casserole dish with cooking spray
- Combine all the ingredients for the meatballs and mix thoroughly. Make about 24 meatballs and put them in the casserole dish.
- Bake for 30 minutes or until the meatballs are cooked through. Carefully drain the cooking liquid from the casserole dish.
- Top with the sauce and cheese. Bake for an additional 10-15 minutes or until the cheese is melted.
- Optional: I broiled for 3-4 minutes at the end to toast the cheese. Watch it carefully if you put it under the broiler. The cheese can burn easily.
Notes
Nutrition
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Originally Published September 23, 2016. Revised and Republished September 8, 2025.







Do not broil pyrex. It is not direct heat safe.
I’ve put my pyrex casseroles under the broiler many times. Only for 2-3 minutes, as stated, without an issue. I agree with not using pyrex for long broil times.
Delish!!! My daughter made this for us when she visited and now I keep a bag of these meatballs in my freezer. I didn’t think shredded zucchini would be good in meatballs but you don’t even know it’s there and they taste fantastic
I really liked these meatballs. I followed the recipe exactly and used sweet Italian pork sausage. When I mixed it all together I wasn’t sure how it would come out because the mixture was very wet and mushy but the flavor and texture of the cooked meatballs were probably my all-time favorite. I’m not a huge meatball fan because they often taste just like meat loaf balls and can be dense and dry. These were the opposite. Of course, if you choose a sauce that you really love it only enhances the dish. This will be a go to dish from now on.
Excellent flavor. Easy to make. Family didn’t even notice the zucchini.
Could I use premade frozen meatballs?
You have to check the ingredients. Many have breadcrumbs or other non-keto ingredients added.
Can i use ground beef instead of ground turkey?
Yes, enjoy!
Made recipe today. Made smaller size meatballs. Froze some. Plan to make meatball subs tomorrow with keto friendly hot dog buns! 😋
I made a few adjustments (didn’t have onion & used fresh Basil) I used Parm and Mozza. Wish I could post the picture. You can taste it <3
I have osteoarthritis so I try to not use nightshades in my cooking. I’ll do a mushroom sauce made from button and shiitake.
I was planning to make this for my family but my son and husband found the zucchini and snubbed their nose at it. Made it anyway for my lunches this week with low expectations. Oh my goodness gracious. Not only does it smell amazing while cooking but it is so flavorful and a perfect lunch for this week. They both keep asking what that smell is in the house but I’m not letting them have any. Just sampled one and packed the rest up into a container to take to work. If you can taste the zucchini, you’re doing something wrong. This is going in my recipe box.
Just made them one with spinach and another with out I love the idea of using the broiler for a couple min to get that brown color now to taste sure looks delicious … thanks for sharing your recipe
These were very yummy! Nice size of meatball and 3 of them per serving is perfect. Thank you for the recipe.
Could you add spinach?
Sure
This looks delicious. Can’t wait to make it!
Very tasty! Will definitely make this again!
This looks amazing…going to try it over the weekend!