Meatball Casserole
If you are looking for a comforting new family dinner, this homemade Meatball Casserole is the perfect choice. It features juicy, flavorful meatballs baked until golden, then smothered in rich tomato sauce and melted cheese. This low carb keto meatball casserole is always a massive hit with both kids and adults.

This recipe is inspired by the classic Italian meatball Parmesan subs I loved during college. To make it healthy and low-carb, I skipped the bread and turned it into a comforting, cheesy casserole with meatballs. It delivers all the nostalgic flavors of a classic meatball sub without the carbs.
Love this? Try my Keto Chicken Parmesan next! It is breaded with parmesan cheese, making it lighter than classic chicken parm but just as delicious.
Why You’ll Love This Recipe:
- Family-Friendly Comfort Food: A dish the whole family will enjoy.
- Low Carb & Keto: Packed with protein and completely keto-friendly.
- Meal Prep Ready: An easy make-ahead freezer meal perfect for busy weeknights.
- Hidden Veggies: A great way to sneak vegetables into dinner—kids won’t even notice!
- Sub Without the Bread: Tastes exactly like a meatball Parmesan sub.

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 using lean ground meat, the sausage helps keep the meatballs moist and flavorful.
- 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. Note: I do not squeeze the water from the zucchini for this recipe.
- Shredded Mozzarella Cheese – You can also use a blend of Italian cheese. Use freshly shredded mozzarella for the best melting texture.
- 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: Mix the Meatballs
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. Don’t overmix the meatball mixture or the meatballs can become dense.

Step Two: Scoop and Bake
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°F on my meat thermometer.
💡 Pro Tip: If there is excess grease in the casserole dish after baking, drain it completely before moving on to adding the sauce and cheese.

Step Three: Sauce, Cheese, and Broil
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 Prep Tip💡
You can make the Italian meatballs ahead of time, cook them 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 meal prep idea is always a perfect meal on busy weeknights.
Storage & Reheating
Store any leftovers in an airtight container in the fridge for 3-4 days. Reheat in the oven at 350°F until hot, or microwave individual portions.

Variations
- Fresh Herbs – 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.
- Spice Swaps – Swap the dried minced onion and garlic for onion powder and garlic powder, or sub in Italian seasoning.
- More Dinner Ideas – 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 are 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.
I use a large cookie scoop to simplify the process and make uniformly sized meatballs. 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.
The shredded zucchini helps keep the meatballs moist and tender, and my kids never notice it’s there. If you’d rather use something else, chopped spinach works well too.
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.
Yes. Assemble the cooked meatballs and sauce in the dish, cover, and refrigerate up to 24 hours before baking. Add cheese just before putting it in the oven to reheat.

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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.







I love this! I’ve made it several times and it’s attractive and even better – delish! Tonight I sprinkled shredded fresh basil and oregano from my garden, which was a nice addition.
Thanks for posting this – definitely a keeper.
Super easy and delicious!!
Delicious! Will make many more times.
Love the flavor of these!!! Definitely will make them again and again!
Tried furst time turned out ok.like burger patty.my wife (diabetic) liked it.tx.
This was so tasty – will definitely make again
I love this and keep coming back to make it again! It’s very flavorful and surprisingly easy. Serve with a salad and…nobody misses the carbs. I was so interested the fist time to see how the meatballs would gold together. I guess zucchini is magic! 😊. Thanks for this. ❤️❤️❤️
THE best meatball casserole recipe! I used 3/4 of a jar of Rao’s (the big ones they sell at Costco) and that did it for me. Included the zucchini and also paired with a Caesar salad, and there was dinner! So enjoyed it.
Made many meatballs over the years, but yours are the best. Delicious! A plus that they’re also easy. I used chopped spinach. Thanks for the sub suggestion. Thank you for another wonderful recipe.
BTW, where to find the recipes on your FB page? They didn’t show up on your web site search.
Good consistency and flavor. However, they were way too salty. That might be because I used a jarred marinara sauce? I’ll make this again but not add any salt. There’s plenty in the cheeses and sauce. Also, I used the full jar of sauce, which I would do again.
I found this recipe 2 years ago and have made it twice a month since then. It’s become a staple in our house! I like to use more sauce (up to an entire jar) so that my kids (who are not low carb) have sauce for their pasta. I also use ground chicken instead of ground turkey because we prefer the taste and it comes out perfect every time!
These were awesome! Best meatballs ever! Will definitely make again.
I read in your sauce recipe that you sometimes use the discarded onion in these meatballs, would you add the onion AND the zucchini or is it one or the other? Hoping to make this for dinner this week!
I’d use both. I just chop up the onion and add that too.
Today is Sunday. These are on the menu for Thursday. (My sons fav meal). How much ahead of time can I make them? I usually meal prep on Monday. If Monday works, should I make the balls and NOT cook until Thursday and keep in fridge, or go ahead and cook the first round and just store in fridge until Thursday and cook final round with sauce then?
Cook them on Monday. Then add sauce and the cheese when you reheat.
Amazing! My daughter loves it so much she wants to eat it every week! I did use the Rao’s low carb marinara as opposed to making the homemade sauce but will try it next time around. This is a WINNER and will be on our favorites list! Thank you for this recipe!