Keto Italian Meatball Casserole

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This Italian Meatball Casserole is a super simple dinner with your crockpot doing all the hard work. All you need to do is combine the ground beef, coconut flour, cheeses, and spices; in just a few hours, you’ll have a hearty but low-carb keto meatball casserole. This keto casserole is perfect for family dinners, game days, and get-togethers with friends!

Keto Italian Meatball Casserole


I love this Italian meatball casserole because it’s really simple to make. I had made BBQ meatballs before, so I knew it would be easy to make a couple of changes to the recipe to make keto/low carb Italian Meatballs.

Usually, Italian Meatballs are served over noodles, but instead of making a noodle substitute, we just ate them right out of the casserole dish with a side of buttery broccoli. This recipe is so versatile; if you don’t own a crockpot, you can still bake this casserole; you can change ground beef out with ground turkey! This recipe will quickly become one of your favorites. 

If you’d like to eat with a keto/low carb noodle substitute, you could serve it over spaghetti squash (how to roast a spaghetti squash here) or with zucchini noodles.

Keto Italian Meatball Casserole being served on a white plate


  1. Ground Beef – I used 80/20 ground beef, but you could also sub ground turkey instead.
  2. Cheeses– Parmesan and mozzarella cheese make this taste amazing. 
  3. Coconut flour – Acts as a binder, so all the ingredients stay together. You can sub almond flour instead. 
  4. Eggs – Mix with the coconut flour to make the meatballs form properly. 
  5. Low Carb Spaghetti Sauce – Make certain it’s sugar-free as well; spaghetti sauce also adds moisture to the keto meatballs. 
  6. Seasonings– Use as directed and then taste test. 

Steps to make Keto Italian Meatball Casserole:

Ingredients for keto italian meatball casserole in bowl

Step 1: Combine all ingredients except the low-carb spaghetti sauce, mozzarella, and basil. Stir the mixture until combined.

Unbaked meatballs in pan

Step 2: Place a cast-iron skillet on medium heat on the stove, and cover the bottom of the skillet with coconut or olive oil. 

Step 4: When the oil gets hot, scoop meatballs with a small cookie scoop into hot oil and brown. If you prefer, you can form the meatballs into balls by hand, but I have found that using a cookie scoop or ice scoop is easier. 

meatballs covered in sauce

Step 5: Once the meatballs are browned, place them in the bottom of a crockpot, and pour the low-carb spaghetti sauce over the top of the keto meatballs. Cook on high for 2-3 hours or low 4-5 hours.

Low Carb Marinara Sauce Options without any added sugars:

  • Rao’s Homemade Marinara Sauce – 4g net carbs per ½ cup
  • Rao’s Homemade Tomato Basil Sauce – 3g net carbs per ½ cup
  • Lucini Italia Organic Tuscan Marinara Sauce – 3g net carbs per ½ cup
  • Lucini Italia Organic Rustic Tomato Basil – 3g net carbs per ½ cup
  • Mezzetta Napa Valley Homemade Sauce Marinara – 6g net carbs per ½ cup
  • ALDI Simply Selected Premium Marinara – 5g net carbs per ½ cup

Meatballs covered in sauce, sitting in a pan

Step 7: Scoop out meatballs into a casserole dish. Make sure to spray the casserole dish with non-stick cooking spray, so you can easily scoop out the meatball casserole. 

Keto Italian Meatball Casserole

Step 9: Sprinkle mozzarella cheese, then basil on top. Then, broil in the oven on the top rack for 2-3 minutes or until the cheese starts to bubble and brown. Once out of the oven sprinkle with parsley and enjoy! 

Spoon scooping out meatball casserole from pan


Yum! This keto meatball casserole is delish! It has so much flavor after slow cooking all day in the crock-pot.


  • Even though this simple meatball recipe is ultimately cooked in the crockpot, there is a portion to cook in a cast-iron pan as well. You will fry up the meatballs until the outside has a nice brown crust before adding to a casserole dish. 
  • Use a cookie scoop or ice cream scoop and pack the meatball tightly against the side of the bowl before dropping it into the oil to fry. This makes it so much easier, and it’s not as messy.
  • If you’re worried that they have a lot of grease on them after cooking in the oil, you can place them on a napkin to soak some of it up. 

How to Store Keto Italian Meatball Casserole?

Allow the leftovers to come to room temperature, and then put them into an airtight container. They can be stored in the fridge for 3-5 days. To reheat, add the keto meatball casserole to a saucepan on medium heat and cook to warm through, or place in a microwave at 30-second intervals.

Can You Make these Italian Meatballs Ahead of Time?

Yes. If you want to save a little bit of time and meal prep for later, you can make the meatballs and cook them up in your skillet and have them waiting in the fridge to add to the slow cooker. Slow cooker meatballs can be cooked later after you’ve done minimal prep. 

In addition, you can also forgo cooking them in a skillet, freeze them as raw meatballs, and then brown them once you are ready to cook.

What do I Serve it With?

This is such a simple and easy meal in itself and

What Kind of Topping go with this Keto Italian Casserole?

Fresh parmesan is always a big hit. But you can also add diced onions, parsley, and even some fresh basil and chives. As long as the toppings are low carb, they should be fine to add. 

Mor Low Carb Dinner Recipes:

If you love our simple keto meatball casserole, then I know you will enjoy checking out all of my family’s favorite recipes in my Keto Recipes Index. With tons of delicious sweet and savory options perfect for the keto diet, you will love this tool. I’ve shared a few more favorites below for a quick start to your menu!

How to Make Keto Meatball Casserole:

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4.71 from 57 votes

Italian Meatball Casserole {Keto/Low Carb}

Servings: 6 servings
Calories: 485kcal
Author: Kasey Trenum


  • lb Ground Beef 80/20
  • ½ cup grated parmesan cheese
  • ½ cup mozzarella cheese
  • 2 tablespoons coconut flour
  • 2 eggs
  • ¾ tsp salt
  • ¾ tsp minced onion
  • ¼ tsp Italian seasoning
  • 1/2 tsp garlic powder
  • ¼ tsp black pepper
  • 24 oz jar low carb spaghetti sauce
  • 2 cups mozzarella cheese
  • 1 teaspoon basil to sprinkle on top of cheeses


  • Combine all ingredients except the last three ingredients in a bowl and stir to combine.
  • Heat a cast iron skillet on medium on the stove.
  • Cover the bottom of the skillet with ¼ inch coconut oil.
  • When the oil gets hot, scoop meatballs with a cookie scoop into hot oil and brown.
  • Once the meatballs are browned, place in the bottom of a crock pot.
  • Pour spaghetti sauce on top of the meatballs.
  • Cook on high for 2-3 hours or low 4-5.
  • Scoop out meatballs into a casserole dish.
  • Sprinkle mozzarella cheese then basil on top.
  • Broil in the oven on the top rack for 2-3 minutes or until the cheese starts to bubble and brown.


Low Carb Pizza Sauce Options without any added sugars:

  • Rao’s Homemade Marinara Sauce – 4g net carbs per ½ cup
  • Rao’s Homemade Tomato Basil Sauce – 3g net carbs per ½ cup
  • Lucini Italia Organic Tuscan Marinara Sauce – 3g net carbs per ½ cup
  • Lucini Italia Organic Rustic Tomato Basil – 3g net carbs per ½ cup
  • Mezzetta Napa Valley Homemade Sauce Marinara – 6g net carbs per ½ cup
  • ALDI Simply Selected Premium Marinara – 5g net carbs per ½ cup


Calories: 485kcal | Carbohydrates: 9g | Protein: 33g | Fat: 35g | Saturated Fat: 16g | Cholesterol: 166mg | Sodium: 1394mg | Potassium: 707mg | Fiber: 3g | Sugar: 6g | Vitamin A: 958IU | Vitamin C: 8mg | Calcium: 368mg | Iron: 4mg
Tried this recipe?Mention @kaseytrenumblogger or tag #kaseytrenumblogger!

Keto Italian Meatball Casserole


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  1. I am confused one part of the recipe says coconut flour the other says coconut oil is it both?

    1. Coconut flour is in the recipe, coconut oil is used in the pan before cooking the meatballs.

    1. I just baked this in the oven at 350° for about 30 min, then topped with the cheese and broiled as directed. The family loved it! Browning the meatballs first is key 😉

      I should note that I more than doubled the recipe, though — I used 3lbs ground beef and adjusted the recipe accordingly — so your cooking time may vary.

      Thanks so much for this recipe!

  2. 5 stars
    I didn’t read all of the instructions before beginning to make the meatballs that it was a crockpot recipe. Not having hours to spend – I decided to make it in my foodi ninja instead. I followed the instructions up to putting in the crock pot, I instead put them in my foodi. I also didn’t have spaghetti sauce so I used pizza sauce. I set the foodi to pressure cook on high for 15 mins. After it finished I did a quick release on the pressure. Then sprinkled the cheese (a mixture of provolone and mozzarella) and the basil on top and used the air fryer lid to broil it for 3 mins. It turned out PERFECT. Thank you for the recipe. The meatballs are great on their own but served over some zucchini noodles would probably make it that much better 🙂 DELICIOUS!

  3. This recipe is amazing! The entire family enjoyed it! I think it’s now my new favourite! Thanks for posting such great recipes!

  4. Do you think I could just mix and roll the meatballs and leave in the fridge until ready to cook? I am meal prepping for the week and wanted to make them on Tuesday night.

    1. I bought a Mezzetta but the roasted garlic so it says 10 carbohydrates. Oops but still not too bad.

    1. The nutritional info is for six servings. You will just need to do the math, according to how many meatballs you make.

  5. This is in the crock pot right now but I can already tell this will be a keeper, smells so good I can’t wait until dinner! Thanks for all the great recipes you provide us, they are appreciated!

  6. 5 stars
    Excellent!! My son doesn’t like much that I cook these days but he loves this and told me this was a keeper! High praise, Kasey!

    I wasn’t totally prepared to make this so this shows that you can still turn out a delicious dinner in a shorter period of time. I followed the recipe for ingredients but did season a little heavier. Since it was close to dinner time, I made the meatballs and baked in the oven. They did spread a little bit but nothing noticeable to my family. I used two jars of low carb spaghetti, adding basil, salt, pepper, garlic powder, and a couple drops of ezsweet. Simmered the sauce while the meatballs baked, then added the meatballs to the sauce to gently simmer for a little bit. (Note I cleaned off the meatballs – foamy stuffy). I served over angel hair pasta for family and palmini pasta for me. Topped with mozzarella and Parmesan cheese. So delicious! Will definitely make the casserole version next time. My son loved the cheese in the meatballs!!

    1. Please note that I used minimal sauce on mine. Changing amounts does change carb count so adjust accordingly.

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