This mouthwatering keto meatball casserole is super cheesy and full of fabulous Italian flavor. Simply throw all of the ingredients together and let your slow cooker do the work for you!
A white plate with keto meatball casserole on top of shiritaki noodles.

Mouthwatering keto meatball casserole is super cheesy and full of fabulous Italian flavor. Simply throw all of the ingredients together and let your slow cooker do the work for you! This easy keto dinner recipe is a new family favorite.

A wooden spoon lifting some keto meatball casserole out of a slow cooker.


 

Let me just say that it is extremely hard to get good photos of this keto meatball casserole in the dreary winter light. Especially when your slow cooker happens to be black.

But it is a remarkably scrumptious recipe so regardless of my photography, I urge you to make it as soon as possible.

When I posted my keto meatball recipe the other day, I promised you some tasty ways to use them. And this cheesy, saucy meatball casserole is the real deal.

Keto meatball casserole on a white plate with a glass of wine and a wine bottle in the background.

Making your own frozen meatballs

One of my frustrations on keto is the fact that I can’t purchase things like a bag of pre-made meatballs. They make weeknight meals so easy and streamlined.

Most meatballs you find in the freezer aisle have breadcrumb fillers and a significant amount of carbs. And the gluten-free versions are just as bad, and sometimes even worse.

I did come across one brand of paleo and keto meatballs at one point, but they were exorbitantly expensive and required online ordering. That’s just not practical for any of us.

Making your own keto meatballs may be more effort, but it’s worth it. And making a big batch means you can freeze them and have them ready whenever you need it. They cook directly from frozen!

Keto meal prep meatballs in a freezer bag.

How to make keto meatball casserole

This easy keto meatball casserole takes only four ingredients that get layered together in a slow cooker. But the quality of your ingredients matters.

Let’s discuss:

Keto meatballs

This assumes that you’ve made a batch of keto meatballs in advance. It uses half of my meal prep meatball recipe. But you do have options. Check out the Frequently Asked Questions for tips on using other meatballs.

Low carb marinara sauce

It’s not always easy to find no-sugar-added marinara sauce, but there are a few good brands out there. Rao’s is extremely popular. Another good one is Yo Mama’s Foods. Look for brands that have no more than 5g of carbs per 1/2 cup serving. Be sure to check the serving size, as many list it as only 1/4 cup.

If you can’t find a good low carb marinara, make a quick tomato sauce using 1 1/2 cups of diced tomatoes. Blend them up and add a bit of garlic powder, salt and pepper to taste, and a sprinkle of Italian seasoning.

Shredded mozzarella

I recommend getting a block of whole milk mozzarella and grating it yourself, to save carbs. I ran the numbers on this with pre-packaged part-skim cheese and it was almost a full carb higher. Of course, convenience is a factor too, so do what suits you best!

Grated Parmesan

I also recommend grating your own Parmesan. Not because it changes the carb count but because it has better flavor. Whatever you do, don’t use the stuff from the green can. It’s just not good!

4 photos showing the steps for making keto meatball casserole.

Frequently Asked Questions

Do I have to make your meatball recipe or can I make a different one?

Make whichever recipe you like! Just be sure to cook them through fully before freezing, so that you can add them to the keto meatball casserole safely. You will need about 24 ounces of meatballs for this recipe.

Can I add the meatballs when they’re fresh?

You can definitely do that too. You still want them to be fully cooked, as raw meatballs give off a lot of juice and grease as they cook, and will make a mess of your casserole. Set the slow cooker for 2 1/2 hours on high or 4 hours on low.

I don’t have a slow cooker, can I make this keto meatball casserole in the oven?

Absolutely. Place all of the ingredients in a glass or ceramic baking dish and cover with foil. Bake at 375ºF for 45 minutes, then remove the foil and bake another 5 to 10 minutes, until the cheese is melted.

If you’re using fresh meatballs, you will only need about 20 minutes for the first step.

Can I make this in an Instant Pot?

The trouble with pressure cookers is that they force a lot of liquid out of the ingredients, so I worry that your keto meatball casserole would be very soupy. But you could use the slow cooker setting on your instant pot, if you have that.

A white plate with keto meatball casserole on top of shiritaki noodles.

What to serve with keto meatball casserole?

Craving some keto pasta or another side to soak up all the delicious sauce? I’ve got a few ideas for you!

  • Shiritaki noodles – some people don’t love them, but as long as you rinse them properly, you really don’t taste much besides the delicious meatballs and sauce.
  • Palmini – these are noodles made from hearts of palm. I think they’re serviceable and again, you won’t taste them much when paired with the casserole.
  • Zucchini noodles – I am always a fan of zucchini noodles and I like to cook them quickly in the microwave. I find 30 to 60 seconds for an individual serving to work perfectly for al dente.
  • Creamy mashed cauliflower – you aren’t limited to noodles, my friends. Mashed or riced cauliflower is a great way to soak up this delicious sauce.
  • Keto Egg Noodles – if you’re up for a challenge, you’ve got to try the noodles from Keto Asian Flavours. They get rave reviews! I have all the ingredients and plan on trying them myself soon.
A fork digging into a plate of keto meatball casserole.
A white plate with keto meatball casserole on top of shiritaki noodles.
5 from 9 votes

Keto Meatball Casserole

Servings: 6 servings
Prep Time 10 minutes
Cook Time 4 hours
Total Time 4 hours 10 minutes
This mouthwatering keto meatball casserole is super cheesy and full of fabulous Italian flavor. Simply throw all of the ingredients together and let your slow cooker do the work for you!

Ingredients
 

Instructions

  • Place the frozen meatballs in the bottom of a 6 quart slow cooker. Pour the tomato sauce overtop.
  • Sprinkle with the cheeses and cook on high for 3 to 4 hours, until melted and bubbly. Serve over your favorite keto noodles or cauliflower mash.

Nutrition

Serving: 1serving = about 4 meatballs | Calories: 458kcal | Carbohydrates: 7.3g | Protein: 40.1g | Fat: 27g | Fiber: 1.9g
I’d love to know your thoughts, leave your rating below!

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5 from 9 votes (3 ratings without comment)

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14 Comments

  1. 5 stars
    Hi Carolyn, These were great meatballs! I made them fresh, let them cool and put them right into the casserole recipe. I made the mashed cauliflower to go along with it. I made it for the hub, knowing he had a rough day and would need some comfort food. He loved it and so did I! It brings me back to the days when I would have a meatball grinder…hmmmm!

  2. Caroline Nielson says:

    5 stars
    These were so easy to make and soooo delicious!! My 80 year old dad praised them. I also made the meatball recipe and I now have 40 meatballs in my freezer ready for more wonderful dinners. Thank you!!

  3. 5 stars
    This meatball casserole is INCREDIBLE!! So tasty and addicting!

  4. wilhelmina says:

    5 stars
    Comfort food is something I really crave on keto. This meal totally hit the spot. This is such a winner. I love all of your tips too, thanks!

  5. 5 stars
    Soooooo delicious. I am all about that slow cooker life – these meatballs did not disappoint.

  6. 5 stars
    Absolutely Delicious! We had them tonight over zucchini noodles. The BOMB! Thank you, for another awesome recipe :-))).

  7. Do you have a recipe for a low carb tomato sauce

    1. I provided instructions for that right in the blog post! 🙂

  8. Esther R. says:

    So good !! I hope everybody tries this . It’s delicious !!!

  9. For low carb sauce I like to use Classico Tomato and Basil. It has 6 net carbs per half cup – That is 1 carb higher than the Rao’s brand but is free from junk ingredients like seed oil and has no sugar. It often goes on sale in my area for 1.49 – 1.99 which is much less expensive than the other low carb brands. Thought I would mention it in case that would help another reader.

  10. Corliss Nilsen says:

    I do enjoy all your ideas and tips.

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