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Spaghetti Squash Pizza Casserole

Spaghetti Squash Pizza Casserole

This is a favorite of the whole family. My kids have no idea that the base of this casserole is all vegetables. ???? They taste the flavors of pizza and forget about everything else.
Course Main Course
Servings 6



  • 1 medium spaghetti squash
  • 1 Tbsp olive oil
  • ¼ lb ground beef
  • ¼ lb Italian sausage
  • ¼ yellow pepper diced
  • 2 Tbsp sliced green onions
  • 1 cup packed chopped fresh spinach
  • 1 egg beaten
  • ½ cup shredded mozzarella cheese
  • ¼ cup parmesan cheese
  • Salt, pepper and garlic powder to taste
  • Non-stick cooking spray


  • 15 oz jar of marinara sauce no added sugar
  • Basil and oregano to taste
  • 10 large slices pepperoni halved
  • 1 cup cottage cheese
  • 1 cup mozzarella cheese
  • ¼ cup parmesan cheese
  • 1 egg beaten


How to cook the spaghetti squash

  • Preheat oven to 350°F and line a baking sheet with parchment paper.
  • Pierce the spaghetti squash with a knife about 4 times on all sides. Place squash on a microwave safe plate and cook for about 4 minutes. Once cool enough to touch, slice squash in half lengthwise and remove seeds. Rub both sides of squash with olive oil and sprinkle with salt, pepper and garlic powder. Place squash cut side down on prepared baking sheet and cook in oven for 30- 40 minutes, or until tender to the touch.  Remove from the oven and flip the squash so that it’s cut side up. Set aside to cool.
  • Remove the parchment paper from your baking sheet and line sheet with paper towels. Using a fork, scrape the strands out of the squash shell from the outside in and discard shell. Place squash on paper towels and allow moisture to drain from strands. Before continuing, squeeze remaining moisture from squash with additional paper towels. This is very important, so your casserole is not watery.

Preparing the casserole

  • While spaghetti squash is cooking, place ground beef and sausage in a skillet and sauté until cooked through. Drain grease.
  • Spray a 7 x 11” or 9 x 13” baking dish with cooking spray.
  • Place squash in a large bowl and add all remaining “crust” ingredients. Mix until well combined. Add mixture to baking dish and smooth with a spoon into an even layer.
  • Using the same bowl, combine marinara sauce with basil and oregano if needed. Top the crust with the sauce.  Top the sauce with the pepperoni slices.
  • In the same bowl, mix cottage cheese, mozzarella, parmesan and egg. Smooth in a layer over pepperoni.
  • Bake 30-40 minutes, or until sauce is bubbling and cheese layer is melted. Cut into squares and serve hot.
Keyword Anti-Inflammatory, Beef, Bell Pepper, Complete Meal, Entree, Keto, Pork, Spinach, Squash