Paleo pizza casserole is a healthy twist on a classic family dish. Packed full of vegetables and meat with a pizza flavor, this will be a new favorite around the dinner table. It is totally customize able to your pizza topping liking.

Who doesn’t love pizza? I sure don’t know anyone that doesn’t. I’m a huge pizza fan and so are my husband and kids. My son even asks for this meal so it is kid approved. I wanted to create a recipe reminiscent of pizza but low carb- so packed with lots of vegetables and meat. Spaghetti squash is a wonderful replacement for noodles and is full of vitamins B6, C and fiber. This is a great option if you are paleo or doing a Whole 30. It is gluten and dairy free but you can add cheese or any other vegetables to make it customize able.
Ingredients Needed:
- Spaghetti squash
- Marinara Sauce or Pizza Sauce
- Ground Pork
- Pepper
- Onion
- Black Olives
- Mushrooms
- Pepperoni
- Oregano
- Basil
- Cilantro
- Garlic

How To Make Paleo Pizza Casserole
There are several ways to bake a spaghetti squash from baking in the oven (my preferred way), stove top, slow cooker, or instapot. Since I bake in the oven, I will share those instructions but feel free to cook the squash the way you prefer. For the spaghetti squash, I cut open, de-seed and place on a cookie sheet with the shell side up.
Place cookie sheet in a 350 degree oven for 45 minutes.
While the squash is baking, I prep all the vegetables and brown the meat.
After the squash is cooked, using a fork I pull the squash from the shells and place in a large bowl. In the bowl, I combine the meat, marinara sauce, spices and vegetables.
Transfer evenly into a 9 x 13 casserole dish and top with pepperoni.
Place back in oven covered for 10 minutes, take out and serve.
What I love about this recipe:
- Low carb– the spaghetti squash is very filling and delicious. You can enjoy this and not feel so stuffed like pasta and bread based recipes can sometimes make you feel.
- Vegetables– loaded with veggies which are also so good for you. It is a great way to get veggies in that the kids will enjoy.
- Meal Prep– this is an excellent dish to meal prep on Sunday for weekly lunches or a quick pop in the oven meal for a busy weeknight. It’s also an excellent freezer meal option or meal to take to a new mom or sick friend.

Can I Make Paleo Pizza Casserole Ahead Of Time?
Sure, it is a fantastic meal prep option. It freezes well and can be taken out and warmed up easily.
Great As Leftovers Or Share With A Friend
Paleo pizza casserole can be very filing so don’t be surprised if you have some leftovers. These make great lunches to take to work or school.
Have a neighbor that just had surgery? Potluck at church or co-op? A new post-partum mom? This would be a great meal to share with others. Everyone loves pizza flavors especially kids of all ages.
Tips For The Best Paleo Pizza Casserole
- You can use marinara sauce and add the spices listed (oregano, basil, garlic, cilantro) or you can use pizza sauce which has the pizza flavors already. I like the Rao’s brand of pizza sauce and you can get it here.
- If you are paleo or doing a Whole 30, check the ingredients in the pepperoni. Union brand is compliant with no nitrates or sugar. I get mine here.
- This recipe is totally customize able to whatever veggies or even meat you want on a pizza. Have fun with it!

How Do I Store Leftover Paleo Pizza Casserole?
This casserole can be stored in the refrigerator in a sealed container for 3-4 days. I’m sure they will be gone by then especially if you have young kids or hungry teenagers. If you are freezing, place in an airtight freezer container or freezer safe bag. It should freeze well for up to 3 months. When re-heating, set oven to 350 degrees and heat for 10-15 minutes or until desired warmth.
Check out these weeknight meals:
- Paleo Hamburger Casserole
- Asian Beef Skillet
- Sausage, Potato and Veggie Sheet Pan meal
- Creamy Bacon Ranch Stuffed Spaghetti Squash Bowls

Paleo Pizza Casserole
- Total Time: 55 minutes
- Yield: 4 1x
- Diet: Gluten Free
Description
Paleo pizza casserole is a healthy twist on a classic family dish. Packed full of vegetables and meat with a pizza flavor, this will be a new favorite around the dinner table. It is totally customize able to your pizza topping liking.
Ingredients
- 1 medium spaghetti squash
- 1 24 oz jar marinara sauce or pizza sauce
- 1 lb ground pork
- 1 green pepper
- 1 onion
- 1 can black olives
- 1 1/2 cup mushrooms
- 24–30 pepperoni
- 1/4 tsp oregano
- 1/4 tsp basil
- 1/4 tsp cilantro
- 1/4 tsp garlic powder
Instructions
- Instructions for baking spaghetti squash: Pre-heat oven to 350 degrees. Cut spaghetti squash in half and de-seed. Place squash bowls with the shell up and bake for 45 minutes.
- Prep all vegetables- cut peppers and onions into 1 inch pieces.
- In a medium skillet, brown the meat.
- After taking out the spaghetti squash, using a fork pull the squash strands off and place in large mixing bowl. Discard the shell.
- Add in the meat, vegetables, sauce and spices, then mix together.
- Place in a 9 x 13 casserole dish and top with pepperoni.
- Cover and heat on 350 degrees for 10 minutes.
- Take out and let cool before serving.
Notes
- If not dairy-free, add cheese as a topping before heating in the oven.
- Spaghetti squash can be cooked several ways: baking, stove top, slow cooker and instapot. Use whatever method that you prefer. This may change the total recipe time.
- If using a pizza sauce, you don’t need to add in the spices listed. If you are using a basic marinara sauce, you will want to add the spices for the pizza flavor.
- Prep Time: 45 minutes
- Cook Time: 10 minutes
- Category: Main Dish
- Method: Bake
- Cuisine: American
Keywords: paleo pizza casserole, pizza casserole, meal prep, healthy dinner
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