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Keto Meatball Casserole

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4.99 from 225 votes
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If you are looking for a new family dinner this Keto Meatball Casserole should be it. Juicy, flavorful meatballs baked until golden and then covered with tomato sauce and cheese. My low carb Meatball Parmesan Casserole was a hit with my family and should be a hit with yours. 

meatball casserole in baking dish

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 terriffic.

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.

collage of food
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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. 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. This easy family dinner is also low carb, gluten-free, grain-free, and a THM S recipe.

Spoon of cheesy Meatball from Meatball casserole dish below

Ingredients 

To make this meatball casserole you only need a handful of common 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. If you are doing low carb or keto just watch for added sugar in the sausage.

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

ingredients in a large glass measuring bowl

How to make a Keto Meatball Casserole

Step One: I just dump all the ingredients in a large mixing bowl and mix it by hand. In the photo above you can see all the different layered ingredients for the low carb meatballs in my meatball parmesan. For a bowl of raw meat, it looks pretty nice.

raw meat formed into balls lined on a the bottom of a white baking dish close up

Step Two: Next, scoop the meatballs. 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.

small sized meatballs baked in the bottom of a white casserole dish

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.

Expert 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. I don’t meal prep much but I do do this.

Leftovers: Store any leftovers in an airtight container in the fridge for 3-4 days.

shredded cheese covering meatballs and sauce layered in a white casserole dish

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.

Common Questions

What should I serve with meatball casserole?

Our family 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.

A Cookie Scoop for Meatballs?

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.

Do I Have to use Zucchini?

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. You can also just leave the green stuff out and serve this with some Caesar salad, green beans, or roasted broccoli. The low carb meatball parmesan will still work.

Can I Freeze Keto Meatballs?

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. Those and frozen taco meat have saved us from spending too much money on take-out more than once.

What Casserole Dish Should I Use?

I need to give a little shout out to the Emile Henry ceramic company for this beautiful casserole dish. I absolutely love it. It is gorgeous, distributed the heat evenly for this casserole, and washed up in a cinch.

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.

close up of the keto meatball casserole in a baking dish

 

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Spoon of cheesy Meatball from keto Meatball casserole dish below

Keto Meatball Casserole

Taryn
If you need family dinner this Meatball Casserole should be it. Flavorful low carb meatballs covered in sauce & cheese for the best meatball parmesan ever.
4.99 from 225 votes
Prep Time 15 minutes
Cook Time 45 minutes
Total Time 1 hour
Course dinner, Main Course
Cuisine American, Italian
Servings 8 servings
Calories 382

Ingredients
 
 

Meatball Ingredients:

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.

Video

Notes

Nutrition: the nutrition facts are for one serving. This recipe has 8 servings. Each serving is 3 meatballs with sauce and cheese and has 4 NET carbs.
Substitutions: you can use any type of ground meat (beef, pork, turkey, chicken) and any type of Italian sausage (pork, chicken, or turkey) in these meatballs.
You may also omit the zucchini or sub in chopped spinach if you prefer.
Make sure you choose a no sugar added marinara or make your own!

Nutrition

Serving: 3meatballsCalories: 382Carbohydrates: 5gProtein: 36gFat: 24gSaturated Fat: 11gCholesterol: 129mgSodium: 734mgPotassium: 543mgFiber: 1gSugar: 2gVitamin A: 477IUVitamin C: 8mgCalcium: 298mgIron: 2mg
Love this recipe?Please leave a 5 star rating!

Originally Published September 23, 2016. Revised and Republished April 24, 2023.

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243 Comments

  1. Just had these for dinner with a side of broccoli. OMG, so delicious! My hubby went back for seconds and he isn’t even doing keto. I subbed the zucchini with chopped spinach since that is what I had. Can’t wait for leftovers tomorrow night! Thanks for a great recipe!5 stars

  2. Delicious! Made these almost exactly as recipe states. (Substituted granulated garlic for minced). Everyone ate them-keto followers or not. They are gone!5 stars

  3. So delicious! I’ve just started attempting low carb and this was the perfect dish for me and my boyfriend. He put his on a roll and said it was better than the sandwiches he always orders.5 stars

    1. 3. It says at the top there are 8 servings and in the directions that this makes 24 meatballs. Enjoy!

  4. These were excellent! I didn’t find the cookie scoop helpful and ended up rolling them myself. I used meatball mix..I’m only cooking for myself, but great tasting and plenty of leftovers. It’s a keeper for sure. Thanks for sharing!

  5. This was delicious!! And easy! Enjoyed with a crisp green salad and was completely satisfied. Keto isn’t an easy diet to follow especially the first week, but this meal was perfect and I made extra for leftovers 😁5 stars

  6. So delicious!! I used half the mozzarella and left out the salt to lower the sodium. My 4 year old is the pickiest eater and he loved them! Excellent recipe!5 stars

  7. Our whole family loved this recipe, young kiddos included. The zucchini added extra nutrition and moisture to the meatballs. We were all pleasantly surprised by how good and flavorful this dish was (using ground turkey and regular Italian sausage). We followed the recipe to the “t”. It was quite easy, too! Delicious! We’re going to check out your other recipes now.5 stars

  8. I made this the other night for my husband and I.

    I had ground beef in the freezer and a pack of Italian sausages in the fridge that I just removed the casing from. I wanted to use the Zucchini, but my last one had spoiled so I left it out and served the casserole with cauliflower instead.
    This was DELICIOUS!! My husband just raved about it, and there are plenty of leftovers for the week (Hubz works crazy hours so if he has to be very late, leftovers are the easiest thing to do because I don’t eat dinner without him) or I can freeze if we don’t eat them up.

    Thank you so much for this recipe! I’ll be back for more. 🙂5 stars

    1. At what stage did you freeze it? Are the meatballs frozen individually? Or is the whole thing frozen in a casserole dish including the sauce and cheese? It will probably take a few minutes longer if you use frozen meatballs and fresh sauce and cheese. If the whole thing is frozen together it might be 10-15 minutes longer. I’m not sure exactly.

      1. I had just separated and froze the meatballs. Do I need to thaw them out? What the best process?

      2. Did you freeze before or after baking them? I freeze after baking but before adding sauce and cheese. Then I add them to the casserole dish still frozen and top with the sauce and cheese.

  9. Awesome recipe! My hubby and I really loved this. We used 2lbs. of grass fed ground beef and it was still very flavorful! Hubby was surprised that we couldn’t detect the zucchini in it. Definitely making this again!5 stars

    1. The fiber content is under 1 gram so it doesn’t show up. There isn’t a difference between total and net carbs for this recipe.

4.99 from 225 votes (129 ratings without comment)

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