Low-Carb Supreme Pizza Casserole

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This Low-Carb Supreme Pizza Casserole has no crust, but you won’t miss it a bit when you dig into the delicious sausage, pepperoni, peppers, onion, and cheese.

» You might try these Keto Pizza Stuffed Peppers or this Keto Reuben Casserole.

Low-Carb Supreme Pizza Casserole

Being on a low-carb or keto diet doesn’t mean you have to entirely give up things you love, like pizza. In fact, all of the toppings you love to eat on pizza are perfectly acceptable on a low-carb diet.

So why not eat the toppings and skip the crust?

When I first started on a low-carb diet, I was looking for different types of crust to use for pizza. I made a few alternatives, like Fathead crust, which I really liked, but I wanted to give it a try without the crust.

This recipe is so easy to make because all you do is combine all the toppings from your typical supreme pizza in a casserole dish, mix it all up, and bake it for 25 minutes.

Low-Carb Supreme Pizza Casserole

What Toppings to Use

The toppings I use are:

  • Pork sausage
  • Pepperoni
  • Mushrooms
  • Green bell pepper
  • Onion
  • Mozzarella
  • Chopped canned tomatoes

You can mix and match the ingredients you use, based on what you like, or what you have on hand. Additional toppings you can include:

  • Ham
  • Pineapple (in moderation – it adds more carbs)
  • Spinach
  • Olives
  • Chicken
  • ….whatever you want, it’s your pizza!

We eat this casserole all the time. It’s one of our all-time favorite low-carb meals. Once you try it, you’ll see why. It’s so flavorful. And it fulfills the craving for pizza, even without the crust.

Is Supreme Pizza Casserole Low-Carb?

Following this recipe, each serving of pizza casserole has 5 net carbs, all from veggies.

There are a few things ingredients that can quickly make it not so keto friendly, if you’re not careful. So if you’re keeping keto, it’s wise to be aware of these things. They are the pork sausage and the tomato sauce.

Did you know that a lot of store-bought sausage contains added sugars? I have found that especially Italian sausage can come packed with extra carbs you weren’t expected. For this reason, I avoid buying packaged sausage and just stick with plain ground sausage meat. I can then add my own spices when I’m browning it, and avoid any surprises.

A great source for plain ground sausage meat is Butcher Box. It’s a meat subscription box that’s delivered to your door monthly with the cuts of meat you choose. All the meat is humanely raised and never given antibiotics or added hormones. I appreciate the peace of mind that gives.

Secondly, the pizza sauce you use can be quite high in carbs. Tomatoes themselves do have carbs. There are 4 net carbs in 100 grams of ripe tomatoes. In contrast, there are 12 net carbs in 100 grams of jarred pizza sauce. For this reason, I prefer to make my own from canned chopped tomatoes.

How to Make Low-Carb Supreme Pizza Toppings Casserole

Begin by browning the sausage meat. Add half the Italian seasoning and some salt and pepper as you cook.

Meanwhile, pour the chopped tomatoes and tomato paste into a small saucepan over medium heat. Add the rest of the Italian seasoning, plus salt and pepper. Simmer for about 10 minutes, or until it is slightly reduced.

pizza toppings in casserole dish

Add all the other ingredients (mushroom, onion, bell pepper, pepperoni, and cheese) to a casserole dish. When the sausage is done, add it to the mix. Then add the tomato sauce over the top and stir it all up.

Add additional mozzarella cheese to the top and bake for 25 minutes on 350 degrees F.

pizza casserole

When the casserole comes out of the oven, the cheese is bubbling, the flavors have all melded together, and it smells so good. You won’t be able to wait to dig into it.

supreme pizza casserole

Questions About Supreme Pizza Casserole

Can I use different toppings?

You can use any toppings you like in this casserole. The typical ingredients are displayed in the recipe card, in case you want to go traditional. Otherwise, see above for some other options of toppings you might like.

How many carbs in each serving?

This casserole has 7 total grams of carbs with 2 grams of fiber. That makes 5 net grams of carbs per serving. It’s a great casserole to make when you don’t want the extra carbs of a pizza, but you still want the flavors you adore.

Can I freeze the leftovers?

If you have any leftovers, you can freeze them in an air tight container in the freezer for up to 2 months. If you want to freeze the casserole before baking, that’s okay too. It can be frozen and then baked in the oven as suggested in the recipe card, with a bake time of 35-40 minutes.


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pizza casserole

Low-Carb Supreme Pizza Casserole

This Low-Carb Supreme Pizza Casserole combines your favorite pizza toppings without the crust.
4.63 from 16 votes
Print Rate
Course: Main Course
Cuisine: American
Keyword: Pizza, Pork
Prep Time: 15 mins
Cook Time: 25 mins
Total Time: 40 mins
Servings: 4 servings
Calories: 310kcal
Author: Laura


  • 1/2 pound pork sausage
  • 10 slices pepperoni halved
  • 6 large mushrooms sliced
  • 1 green bell pepper chopped in bite-sized pieces
  • ½ onion chopped in bite-sized pieces
  • 1 cup chopped tomatoes canned
  • 1 tablespoon tomato paste
  • 2 teaspoons Italian seasoning divided
  • Salt and pepper to taste
  • 1 cup mozzarella cheese grated


  • Browning the sausage meat in a large skillet over medium-high heat, about 8 minutes, breaking it up into small pieces. Add half the Italian seasoning, salt and pepper.
  • While the meat is cooking, add the chopped tomatoes and tomato paste to a small saucepan over medium heat. Add the remaining Italian seasoning, plus salt and pepper. Simmer for about 10 minutes, or until slightly reduced.
  • Add the remaining ingredients (mushroom, onion, bell pepper, pepperoni, and half the cheese) to a casserole dish. When the sausage is done, add it to the mix. Then add the tomato sauce over the top and stir it all up. Sprinkle the remaining mozzarella cheese over the top.
  • Bake for 25 minutes on 350 degrees F.


Calories: 310kcal | Carbohydrates: 7g | Protein: 18g | Fat: 24g | Saturated Fat: 9g | Cholesterol: 68mg | Sodium: 698mg | Potassium: 451mg | Fiber: 2g | Sugar: 3g | Vitamin A: 400IU | Vitamin C: 31mg | Calcium: 176mg | Iron: 2mg

The information shown is an estimate provided by an online nutrition calculator. It should not be considered a substitute for a professional nutritionist’s advice.

Read More About a Low-Carb Lifestyle

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Low-Carb Supreme Pizza Casserole
Low-Carb Supreme Pizza Casserole

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