Italian Sausage Casserole (Paleo + Whole30) | The Real Simple Good Life
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Italian Sausage Casserole (Paleo + Whole30)

With a creamy, smoky sauce that’s baked in with all the other savory ingredients, this Italian sausage casserole is a different type of healthy casserole. Simple ingredients combine to make this Whole30 casserole something you’ll be able to share with your family and friends!

Sausages and bell peppers in a casserole dish over creamy cauliflower

How do you make comfort food healthy?

We love making dishes with real food ingredients that feel like comfort food. A lot of people think healthy eating is boring, but this Italian sausage casserole proves that it’s definitely not. It feels like the ultimate comfort food, filling and flavorful. Here are some of the real food “swaps” we made with this recipe:

  • Homemade sauce – It’s a creamy, smoky, dairy-free sauce that whips up in 2-3 minutes. Believe me, it’s better than anything you get in a can or box.
  • Cauliflower rice – An easy sub for white rice or noodles. Plus, it soaks up all of the sauce and juices from the other ingredients.
Sauce being poured over cauliflower rice and bell peppers in casserole dish

Finding Whole30 Italian Sausage

It’s not always easy, but you can find Whole30 compliant Italian sausage in stores and online. Or, you can even make your own by combining some simple Italian seasonings with ground pork. Here are some good options:

Sausages and bell peppers in a casserole dish over creamy cauliflower overhead vertical image

An easy casserole recipe

If you are thinking that a homemade casserole will be a difficult and time-consuming recipe, you will be surprised with this one. Since the homemade sauce is quick and easy to make, you really just have to chop a few veggies and throw everything together. If you use pre-riced cauliflower, you can even cut out that step and get this in the oven even quicker.

Sausages and bell peppers in a casserole dish over creamy cauliflower overhead vertical image close up

Some other healthy casserole options

Your turn to try this easy casserole recipe

I promise, no one will be disappointed when you make this Italian sausage casserole! Everyone who tries this recipe will be amazed that it’s healthy and Whole30 approved. Let us know how it goes if you try it. Take a pic to share on Instagram, and tag us @realsimplegood so we can see. Make sure to give us a follow if you don’t already. We’d love to stay connected!

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Split image with text in middle of "italian sausage casserole". Sausages and peppers over creamy cauliflower in top and bottom images.

Italian Sausage Casserole (Paleo + Whole30)

4.84 from 6 votes
Prep Time: 15 minutes
Cook Time: 45 minutes
Total Time: 1 hour
Servings: 8
Author: Justin Winn
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  • 1.5 lbs Italian sausage links (about 6-8 large links)
  • 6 cups cauliflower rice
  • 2 bell peppers, sliced into strips
  • 1 tbsp ghee or coconut oil

For the sauce:

  • 1 cup water
  • 1 lemon, juice of
  • 2 cups raw whole cashews
  • 2 tbsp nutritional yeast
  • 1 tsp smoked paprika
  • 1/2 tsp garlic powder (or sub 1 tbsp garlic oil)
  • 1/2 tsp thyme
  • 1/2 tsp sea salt
  • 1/2 tsp pepper
  • 1/4 tsp cayenne pepper (adjust to taste based on desired spice level)


  • Make the sauce by placing all of the sauce ingredients in a high powered blender. Blend until smooth and creamy and set aside.
  • Preheat oven to 400° Fahrenheit and grease a 9×13 baking dish with ghee.
  • Prepare cauliflower rice if needed. Chop bell pepper as noted.
  • Place cauli rice and bell pepper in the baking dish and mix. Pour in the sauce and mix again to incorporate evenly.
  • Nestle the sausage links into the dish with the veggies.
  • Place in the oven to bake for 35-45 minutes, or until the sausage are cooked through.
  • Remove and allow to cool at least 5 minutes before serving.
Tried this recipe?Take a picture and tag @realsimplegood so we can see it!

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