17 net carbs

Meatball Casserole

Our delicious low-carb meatball casserole is a mouthwatering blend of spaghetti squash, meatballs, marinara sauce, and four cheeses. Perfect for a comforting weeknight dinner or entertaining guests, it offers a delicious solution that’s low in carbs but high in taste.

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Meatball Casserole

Top-view of low-carb meatball casserole served on a white dinner plate.

Low-Carb Meatball Casserole

Total Diabetes Wellness
Introducing our irresistible low-carb meatball casserole, a mouthwatering dish of wholesome ingredients that delivers both flavor and nutrition in every bite. With tender spaghetti squash, succulent meatballs, tangy marinara sauce, and a medley of four cheeses, this dish promises to captivate your senses and satisfy your cravings. Whether you're seeking a comforting weeknight meal or a crowd-pleasing dinner for guests, our casserole offers a delicious solution that's low in carbs but high in taste. Enjoy this savory masterpiece's creamy, cheesy goodness and savor the simple pleasure of good food.
5 from 1 vote
Prep Time 5 minutes
Cook Time 1 hour 30 minutes
Total Time 1 hour 35 minutes
Course Lunch and Dinner
Cuisine American, Italian
Servings 8 servings
Net Carbs 17 g
*Net carbs are per serving


  • large spaghetti squash
  • olive oil spritzer
  • salt and black pepper
  • 26 ounces frozen meatballs
  • 24 ounces marinara sauce
  • 8 ounces ricotta cheese
  • 4 ounces cream cheese, softened
  • ½ cup Parmesan cheese
  • 2 cloves garlic, minced
  • ¼ cup minced parsley, plus more for garnish (optional)
  • 2 teaspoons Italian seasoning
  • 1 cup mozzarella cheese, shredded


  • Preheat your oven to 400F/204C.
    Close-up view of temperature knob on an oven, preheat oven to cook a meal.
  • Cut the spaghetti squash in half, scoop out and discard the seeds. Spritz with olive oil and season with salt and pepper. Place face down on a baking sheet. Bake for 20-25 minutes until the squash is al dente. A quick test for al dente - press on the top of the squash; when it’s slightly tender, it is al dente.
    Top-view of halved spaghetti squash on a baking sheet after cooking.
  • Lower the oven to 375F/190C.
    Close-up view of temperature knob on an oven, preheat oven to cook a meal.
  • Once the spaghetti squash has cooled enough to handle, scoop out the spaghetti noodles into the casserole dish.
    Top-view of cooked spaghetti squash in a casserole dish.
  • Top with the frozen meatballs and marinara sauce. Mix everything together with a spoon.
    Top-view of casserole dish with spaghetti squash, meatballs, and marinara sauce mixed together.
  • In a small bowl, add the ricotta cheese, cream cheese, Parmesan, garlic, parsley, and Italian seasoning. Stir together until blended.
    Top-view mixing ricotta cheese, mozzarella cheese, and seasonings in a small glass bowl.
  • Dollop the cheese mixture over the meatballs and noodles. Use the back of a spoon or spatula to spread the cheese evenly.
    Top view of meatball casserole with cheese mixture spread on top.
  • Sprinkle mozzarella cheese over the top.
    Top view of sprinkling mozzarella cheese on meatball casserole.
  • Bake for 1 hour covered. Remove the cover for the last 10 minutes to brown the top.
    Top view of meatball casserole out of the oven after baking.
  • Garnish with additional chopped parsley. Enjoy!
    Top view of baked meatball casserole garnished with parsley.



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Keywords low-carb spaghetti & meatballs, low-carb spaghetti casserole, low-carb spaghetti meatball bake, low-carb spaghetti squash casserole
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Photos of Low-Carb Meatball Casserole



  • You do not have to use frozen meatballs. If you prefer to make homemade meatballs, you can use those; just ensure they’re fully cooked. The bake time of the casserole will be less with meatballs that aren’t frozen. It should take around 30-40 minutes, or until the cheese is fully melted, golden, and bubbling on the edges.
  • The brand of meatball you use will affect the carb count. This recipe was calculated using Kirkland brand frozen meatballs, which have 4 grams of net carbs per 5 meatballs. If you strictly count carbs, be mindful of the meatballs you select for this recipe.

Marinara sauce

  • The brand of marinara sauce you use may also affect the carb count. This recipe is calculated using Rao’s marinara sauce, which has no sugar and is lower in net carbs than many other brands. If you use a different sauce brand, the carb count may change slightly.

Spaghetti squash tutorial

  • We’ve put together a step-by-step tutorial for how to cook spaghetti squash that you may find helpful if it’s your first time cooking this squash. The most important thing to keep in mind for spaghetti squash is you want the ‘noodles’ to be al dente. If you overcook the squash, the noodles end up soggy, and the texture is not as good.

Spaghetti squash alternatives

  • If you’re not a fan of spaghetti squash, you can completely omit it from this recipe. Without the squash, this recipe is a delicious blend of meatballs and cheese and pairs great with a salad or other vegetable side dish. You can also pair the meatball casserole with zucchini noodles. *If using zucchini noodles, cook those separately and top them with the cooked meatball casserole. Don’t cook zucchini noodles in the same casserole dish; they’ll end up overcooked and soggy.

Frequently Asked Questions

Is this low-carb Meatball casserole recipe Keto?

No, this recipe is not Keto as written. You can modify the recipe to be Keto-friendly by omitting the spaghetti squash from the casserole. This recipe is approximately 11 grams of net carbs per serving without the spaghetti squash.

Is this recipe gluten-free?

Yes! This recipe is naturally gluten-free.

Storage and Reheating Guidelines

  • Make-ahead: Prepare the casserole ahead of time, refrigerate, then bake when ready to enjoy.
  • Storing leftovers: Store cooled leftovers in an airtight container in the refrigerator for up to 3-4 days.
  • Freezing instructions: Freeze cooled casserole in portioned containers or bags for up to 2-3 months.
  • To reheat: Thaw overnight in the refrigerator, then bake or microwave until heated through before serving.

Additional Details

Indulge in the savory delight of our low-carb meatball casserole—a wholesome and satisfying dish designed to tantalize your taste buds while keeping your carb intake in check. Our low-carb meatball casserole offers a delicious alternative to traditional pasta dishes, featuring wholesome ingredients that are both nutritious and satisfying.


Let’s take a closer look at the key ingredients that make our low-carb meatball casserole so irresistible:

  • Spaghetti Squash: This versatile vegetable serves as the base of our casserole, providing a low-carb alternative to traditional pasta. Rich in vitamins, minerals, and dietary fiber, spaghetti squash adds a subtle sweetness and a satisfying texture to the dish.
  • Meatballs: We use frozen meatballs for convenience, but feel free to use homemade if preferred. You can also substitute ground turkey or ground chicken instead of ground beef. 
  • Marinara Sauce: Choose a sugar-free marinara sauce to keep the carb count low. Look for brands that are low in added sugars and artificial ingredients for a healthier option.
  • Cheeses: Our casserole is topped with a blend of ricotta, cream cheese, Parmesan, and mozzarella cheese, adding richness and depth of flavor. These cheeses also provide a good source of protein and calcium.

Preparation Tips

Preparing our low-carb meatball casserole is simple and straightforward. Here are some practical tips to ensure success in the kitchen:

  • Nutrition: Pay attention to the nutritional content of the meatballs and marinara sauce, as they can vary between brands. Check the ingredient list, sugar content, and total carb count to ensure they align with your dietary preferences and needs.
  • Handling Spaghetti Squash: Cutting a spaghetti squash can be challenging due to its tough rind. To make this task easier and safer, pierce the squash several times with a fork and microwave it for a few minutes to soften the rind slightly before cutting. This will make it more manageable to slice in half without exerting excessive force.
  • Baking Spaghetti Squash: When baking the spaghetti squash, be mindful not to overcook it, as this can result in mushy noodles. To achieve the perfect texture, bake the squash until it is just al dente—tender but still slightly firm to the touch. A quick test for al dente is to press on the top of the squash gently; when it yields slightly, it is ready to be removed from the oven.
  • Layering Ingredients: To ensure an even distribution of flavors throughout the casserole, layer the spaghetti squash noodles, meatballs, and marinara sauce directly in the casserole dish. This eliminates the need for extra bowls and simplifies the preparation process.
  • Choosing Quality Ingredients: Selecting high-quality ingredients, such as lean meatballs and sugar-free marinara sauce, can significantly enhance your casserole’s flavor and nutritional value. Take the time to read labels and opt for brands that prioritize natural, wholesome ingredients.

Serving Suggestions

Our low-carb meatball casserole pairs beautifully with a variety of complementary dishes that adhere to your dietary preferences. Here are some low-carb serving suggestions to consider:

  • Side Salad: Create a vibrant side salad with fresh greens, such as spinach or arugula, topped with sliced cucumbers, cherry tomatoes, and a light vinaigrette dressing made with olive oil and vinegar.
  • Steamed Vegetables: Steam a medley of low-carb vegetables, such as broccoli, cauliflower, and green beans, to add a nutritious and fiber-rich element to your meal. Season with herbs and spices for extra flavor.
  • Roasted Brussels Sprouts: Roast Brussels sprouts in the oven with olive oil, garlic, and Parmesan cheese for a deliciously crispy and flavorful side dish that complements the richness of the casserole.
  • Zucchini Noodles: For a pasta-like experience without the carbs, serve the casserole over spiralized zucchini noodles, also known as zoodles. Toss the zoodles with olive oil and sauté briefly until tender.
  • Cauliflower Rice: Swap out traditional rice for cauliflower rice as a low-carb alternative. Simply pulse cauliflower florets in a food processor until they resemble rice grains, then sauté with garlic and herbs for a nutritious and satisfying accompaniment.

Health Benefits for Individuals with Diabetes

Our low-carb meatball casserole offers several health benefits for individuals managing diabetes:

  • Blood Sugar Control: By reducing the amount of carbohydrate-rich foods like pasta and bread, our casserole can help stabilize blood sugar levels and improve insulin sensitivity.
  • Weight Management: Low-carb diets have been shown to aid in weight loss and weight management, which is important for controlling diabetes and reducing the risk of complications.
  • Nutrient Density: With its combination of vegetables, protein, and healthy fats from cheese and olive oil, our casserole provides essential nutrients while keeping carb intake in check.

Our low-carb meatball casserole is delicious, satisfying, and nutritious for individuals seeking to improve their health and manage their diabetes through diet. With simple preparation and wholesome ingredients, it’s easy to see why this dish is a favorite among low-carb enthusiasts and health-conscious individuals alike.

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Recipe Rating

This Post Has 2 Comments

  1. 5 stars
    I don’t leave reviews often, but want to let you know my whole family loves this recipe. I’m trying to watch my carbs and the rest of my family isn’t so it can be tough finding food everyone will eat. This recipe we all enjoyed. Thank you!

    1. Hi Katlynn, thanks for your review! I’m so glad to hear this recipe was a hit for your family 🙂 This is one of my family’s favorite recipes also.