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, 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.

Author: Michele

Prep Time: 10 minutes

Cook Time: 45 minutes

Total Time: 55 minutes

Course: Dinner/Lunch

Cuisine: keto, Paleo, Whole30

Servings: 8

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4.66 from 93 votes

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:

1. 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.
2. 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:

1. Meanwhile, heat a large skillet over medium heat, once heated, add the cooking fat.
2. 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.
3. Once sausage is browned, add onions and stir, cook about 2 minutes until softened, then add garlic and continue to cook another minute, stirring.
4. 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:

1. 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. 

2. 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

Calories: 317kcal

Carbohydrates: 13g

Protein: 10g

Fat: 25g

Saturated Fat: 12g

Cholesterol: 47mg

Sodium: 514mg

Potassium: 454mg

Fiber: 3g

Sugar: 5g

Vitamin A: 215IU

Vitamin C: 10.6mg

Calcium: 69mg

Iron: 2.1mg

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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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