This Sausage Tomato Basil Spaghetti Squash is your new favorite “pasta” combo! A flavorful tomato basil cream sauce is loaded with savory sausage and baked with spaghetti squash. It’s simple, super tasty, and filling! Paleo, Whole30 compliant and keto friendly, too.
Pre-paleo, I had a favorite pasta recipe that I made probably twice per week – not exaggerating. It involved sausage (of course) and a creamy tomato sauce over bow-tie pasta. Super simple, and it was flipping delicious.
Post paleo of course there was no more pasta, but that didn’t mean I stopped making that creamy sausage tomato basil sauce. I’ve used a similar sauce in a couple of recipes – one with sausage and butternut squash, another with chicken.
But now, it felt like the right time to recreate it as a pasta dish once again – this time with spaghetti squash.
You won’t find a ton of spaghetti squash recipes on my site because I’m pretty picky about it. Or rather, I’m not a huge fan of spaghetti squash UNLESS the sauce is just out of this world delicious, which this one is.
And yes, my chicken pesto spaghetti squash falls into that category too, so it’s totally worth trying out if you haven’t!
About the squash, if you’re still on the fence about spaghetti squash, I have a couple of tips coming from someone who’s iffy at best about it.
First, it must be roasted! I like to roast mine after scooping out the insides. Brush it with olive oil and sea salt and roast the two halves face down on a baking sheet. I find this brings out the best flavor possible so you’re starting with a great base.
Second, you need to watch the squash closely so it doesn’t get too soft. Since squash varies in size a ton, there’s no set number to set the timer for, unfortunately. I find a typical medium squash needs about 25-ish minutes to get to a nice “al dente” texture. I like to press it on top to test after about 22 minutes, and go from there.
For this recipe, you’ll make the sauce while the squash roasts so there’s no time wasted. Once both are done, you’ll layer them a few times in a 9 x 13″ casserole dish and bake until heated through – another 15-20 mins.
The leftovers keep perfectly so this recipe is great to make on a Sunday to have all week long for lunches, dinners, or whatever you need. It’s one you’ll love and come back to often, because it’s just that easy and delicious too!
It’s time to cook now – grab those ingredients and find a good knife to cut that squash – let’s go!
Sausage Tomato Basil Spaghetti Squash {Paleo, Whole30, Keto}
Creamy Sausage Tomato Basil Spaghetti Squash {Paleo, Whole30, Keto}
This Sausage Tomato Basil Spaghetti Squash is your new favorite "pasta" combo! A flavorful tomato basil cream sauce is loaded with savory sausage and baked with spaghetti squash. It's simple, super tasty, and filling! Paleo, Whole3o compliant and keto friendly, too.
Ingredients
- 1 med spaghetti squash
- olive oil and salt for roasting squash
- 1 Tbsp ghee or coconut oil
- 1 lb sweet Italian sausage or any Whole30 compliant sausage
- 1/2 tsp crushed red pepper or to taste
- 1 medium onion chopped
- 4 cloves garlic minced
- 1 cup fresh basil torn
- 15 oz can diced tomatoes fire roasted, drained
- 1/2 cup coconut cream or full fat coconut milk
- 1/4 tsp sea salt
- Parsley for garnish
- Extra red pepper flakes salt, and pepper to suit your taste
Instructions
Roast Squash:
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Preheat your oven to 435 degrees. Cut the squash in half, lengthwise, and scoop out the seeds and strings. Brush inside with olive oil and sprinkle with sea salt.
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Place face down on a foil lined baking sheet, and roast in the preheated oven for 25 mins or until the top of squash is just soft enough to push in with your finger. The time will vary depending on the size of the squash.
Make the Sauce:
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Meanwhile, heat a large skillet over medium heat, once heated, add the cooking fat.
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Remove casings from sausage and crumble into the skillet, then sprinkle red pepper flakes over sausage. Use a spatula to break apart the sausage as it cooks. Cook 2-3 mins or until browned and crumbled.
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Once sausage is browned, add onions and stir, cook about 2 minutes until softened, then add garlic and continue to cook another minute, stirring.
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Once garlic is softened, add in the tomatoes, coconut cream or milk, salt and Italian seasoning or fresh herbs. Stir to combine everything, then bring to a boil. Lower heat and allow mixture to simmer 2-3 minutes.
Assemble and Bake:
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Once squash is done, lower oven temp to 400 F. Allow squash to cool long enough to handle. Use a fork to remove the "spaghetti" by scraping squash lengthwise.
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In a large casserole dish, layer the spaghetti with the sausage mixture to evenly mix. Bake in the preheated oven 15-20 mins or until heated through. Enjoy!
Nutrition
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Want More Paleo “Pasta” Recipes? Try One of These!
Zucchini Carbonara {Whole30, Keto}
Sweet Potato Pork Lo Mein {Whole30}
Zucchini Noodle Shrimp Scampi {Whole30, Keto}
Chicken Pesto Spaghetti Squash {Whole30, Keto}
Citrus Grilled Shrimp and Zoodles {Whole30}
Almond Butter Sesame Zucchini Noodles {Whole30, Vegan}
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Does this do well if you freeze it?
Thanks for sharing! Does it keep long?
Very good! I will make this again.very tasty for leftover lunch the next day also. Made this as according to the recipe, except that I used bulk sausage, not from links. I added some sauteed zucchini as a side for bit more vegetable.
I have turned this into my post workout breakfast casserole this week by adding eggs on top and it is delicious! I have been on the keto diet for two months now (mainly to control blood sugar issues) and it’s a total life changer for me. I am so grateful for the timing of your husband’s experiment with the keto diet! This casserole is definitely a keeper!
how much have you lost on the keto diet? I was thinking of starting it but I’m worried I might not be able to get a variety of foods to keep it up and not get bored with it.
This was my first time cooking with spaghetti squash and it was DELICIOUS! I am an absolute pasta lover but I didn’t even miss it with this recipe. Even my husband loved it! I am already looking forward to my leftovers tomorrow!
AMAZING!
So good!!!! Sweet hits you first then a great spice! (If you add more red pepper flakes) Even my picky 5 and 15 year old like it!!! I’m definitely making this again!!!
Hi Michelle, I love your recipes! I am a huge fan of your website. My husband and I are doing Whole30. I am having a hard time finding compliant Italian pork sausage. I don’t want to have to wait on it and order online….I’m finding the grocery stores and other places such as Whole Foods only have it with added preservatives. Any suggestions?
Hi Beth! I’m not very familiar with Whole30, but I was wondering if you’re able to use plain sausage? I just buy plain ground sausage and then add my own seasonings to make it Italian Sausage. I’ve been really happy with the flavor(but I’m also not terribly picky when it comes to Italian sausage). I’d recommend just googling Italian sausage seasoning and going from there. That’s what I did. I don’t want to share the recipe that I use here because I just pulled it from a website and don’t remember which website so I can’t give proper credit lol. Happy healthy cooking!
https://www.tastesoflizzyt.com/homemade-italian-sausage-seasoning/ I made this one, it was amazing
Hi Beth, I know this is a delayed reply, but I have found a compliant sausage called Mulay. I first found it when I was living in WA state, but also here in Colorado. I’m not sure where you live, but my co-op and our Natural Grocers (Vitamin Cottage) sold it. Their website has a store locator. All of their sausage is sugar free. https://www.mulays.com/
Can something be used in place of the coconut milk? Thanks!
Simply delicious!
This dish was AMAZING! I found a recipe for pork sausage and made my own. My husband is like you, never much a fan of spaghetti squash. He loved it, I made this for two and ate it for lunch and dinner with out gettting sick of it.
So good you feel like you’re cheating on your diet!!
Wow! This was delicious! I did make one change…as much as I love coconut everything, I didn’t feel it was the right flavor for this dish. I used cashew cream and it was amazing. Thanks for sharing this wonderful dish!
I have never had spaghetti squash before and had no idea how to make it but this we so delicious. I even shared the recipe with three friends I thought it was so good. Thank you for the amazing recipes our family has enjoyed them.
Made this tonight and was really impressed! Wasn’t sure about adding the coconut cream but the flavours came together nicely. Definitely a make again! Thank you!
Xoxo I have to admit, but idiot me used butternut squash instead if spaghetti. It was MARVELOUS!! It had the perfect balance of sweet, savory and spicy. Will definitely make again. I’ll try it with spaghetti squash this weekend.
This was awesome and a total hit with my co-workers! Even my boyfriend, who typically hates spaghetti squash, said that he enjoyed it. I couldn’t find Whole30 compliant Italian sausage, so I doctored up my own pork sausage with an Italian season blend and fennel. Tasted great!
Thank you for this recipe. I’m not a huge fan of spaghetti squash but this was delicious. The coconut cream, Was, for me the ingredients that made the difference. And I took your advice and made sure the squash was not over cooked thus making sure it wasn’t watery. Thanks again keep up the great cooking
Claire
This one is a keeper! So delicious and easy to make. Thank you!!
Thank you for this great post. Your ketchup recipe is a staple in my kitchen! I just made another batch yesterday ?
This dish is AMAZING!!! I have shared it about 10 times already. My husband is already begging me to make it again.
Can this be made with zucchini instead of spaghetti squash? Squash allergy in the household. ?
Definitely doubling this when I make it again! It’s so delicious!
One of my favorite recipes for low-carb day! So flavorful and easy to make.
I made this recipe, but used almond milk instead of coconut milk, it was delicious! I am going to make this again with black bean spaghetti, since my husband is not a big squash fan.
I’ve made this recipe a handful of times, so I’m leaving a review. I used Turkey meat instead of sausage- skipped the basil bc I didn’t have any & added a bunch more spices and nutritional yeast. It was amazing, better and gone day 2. Enjoy it! It has great flavor and is a good way to incorporate spaghetti squash for healthier options!
My son shared this recipe with me as I have been making mostly Whole30-based recipes over the past year. This is definitely, without a doubt, the BEST THING I HAVE EVER MADE. It is the ONLY recipe in my notebook with THREE STARS at the top. I am making it again this weekend for a friend. Amazing. Thank you!
This is one of the best meals I’ve had in my life. So incredibly simple and delicious.
DELICIOUS! Cooked the spaghetti squash in the Instant Pot to save time, and added mushrooms to the sauce!
I don’t know what it is that makes this recipe taste so phenomenal! The ingredients are super simple, but the flavor that comes out of this is AMAZING! I like spaghetti squash, but this recipe elevates it and makes me LOVE it now! This is in my weekly rotation and makes me forget all about traditional pasta!
This recipe is AMAZING!! I have a very picky eaters and they RAVED about it! Thank you so much!