These zucchini noodles are made deliciously savory with lots of spicy Italian sausage, and a creamy tomato sauce. Quick to throw together on a weeknight and easy to make ahead of time too! It’s a filling, family friendly lunch or dinner that’s Paleo, Whole30, dairy free and low carb too!
Is there any better way to eat your zucchini noodles that with a creamy, satisfying sauce involving spicy sausage? Let me answer that one real fast for you: NO.
This zucchini noodle recipe is somewhat based on a recipe I made years ago constantly that I found on Allrecipes. Was anyone else a total Allrecipes junkie back in the day?
Pretty sure was the only reason I even went on the internet at all back in the early 2000’s. Or at least it was in the top 5 reasons – can’t for the life of me remember the other 4, though.
Anyway, that throwback favorite pasta recipe involved bowties, lots of heavy cream and parmesan, sausage, and diced tomatoes.
It was heaven in a pot, and also one of the only pasta recipes I’ve truly missed since giving up the whole pasta thing altogether.
Now, as many zucchini noodle recipes as I make, I’ll be the first one to tell you that I don’t think zucchini noodles are an actual “sub” for real pasta. Sorry, this is my opinion only and I’m in no way putting down zucchini noodles – I think they’re amazing in their own special, zucchini way.
However, even though I wouldn’t call them a replacement for pasta taste and texture wise, they are AWESOME for recreating some of those old favorite pasta dishes – I mean – wasn’t it really the sauce that made the pasta anyway?!
To make a really awesome zucchini noodle dish though, we need to address the elephant in the room first – the insane amount of WATER in zucchini that we don’t have to deal with when making actual pasta.
So, “sweating” the zucchini noodles and squeezing out tons of water is essential in my opinion before cooking/tossing your zucchini with the good stuff. Don’t worry – I explain how to do this in the recipe details.
Second, the sauce itself needs to be pretty thick, since even after squeezing out water, the zucchini will still thin out the sauce a bit. So, when creating sauces for zucchini noodles I like to up the creamy factor and get rid of water. You’ll see in the recipe details that I not only drained my tomatoes, but soaked up excess water with paper towel as well.
Texture wise, to get your zucchini noodles to be a perfect “al dente”, I don’t recommend cooking them long at all. I basically just toss them with my sauce to heat them, since sweating the zoodles actually makes them quite soft to begin with.
Of course, this step is completely up to you, and, if you’d prefer, you can cook them longer to soften them up.
The other part of this recipe that I love – aside from how yummy it is – is that you can make everything ahead of time, sauce and zoodles separately, and then heat them together to serve. 5 minute dinner, here we come!
Seriously, whether you make this ahead of time or not, it’s easy peasy and packed with flavor. I think we’re ready to get started – get that zucchini spiralized and let’s cook!
Zucchini Noodles with Sausage Tomato Cream Sauce {Paleo, Whole30}
Zucchini Noodles with Sausage Tomato Cream Sauce {Paleo, Whole30}
These zucchini noodles are made deliciously savory with lots of spicy Italian sausage, and a creamy tomato sauce. Quick to throw together on a weeknight and easy to make ahead of time too! It's a filling, family friendly lunch or dinner that's Paleo, Whole30, dairy free and low carb too!

Ingredients
- 4 medium zucchini spiralized
- 1 tsp sea salt to “sweat” the zucchini noodles
- 1 Tbsp organic ghee or coconut oil
- 3/4 lb spicy Italian sausage you can also use sweet Italian and add more red pepper flakes!
- Pinch red pepper flakes
- 1 medium onion chopped
- 4 cloves garlic minced
- 16 oz can diced tomatoes completely drained*
- 1/2 cup coconut cream or full fat coconut milk
- 1/4 tsp sea salt
- 1 tsp Italian seasoning or 1-2 tbsp fresh Italian herbs, chopped
- Parsley for garnish
- Extra red pepper flakes to suit your taste
Instructions
First, “sweat” the zucchini noodles:
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Place zoodles in a collander over a large bowl. Sprinkle the 1 tsp salt all over evenly and allow it to sit for 30 minutes to allow the salt to draw out water.
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After 30 minutes, use paper towels to squeeze the zucchini thoroughly to remove water. Much of the salt will come out with the water, though if you’re sensitive to saltiness, you can rinse the zoodles prior to squeezing water out.
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Once zoodles are squeezed, set them on paper towels while you prepare the sauce.
Then, make the spicy sausage tomato cream sauce:
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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.
Toss with zoodles:
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For “al dente” zucchini noodles, toss in your zucchini noodles with the sauce and allow to simmer for no more than a minute. You can also saute the zoodles separately for about 1 minute if desired, and then toss with the cooked sauce.
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Serve hot and enjoy! See notes for make-ahead options.
Recipe Notes
*After draining, I placed mine in a paper-towel lined bowl to soak up excess water. When dealing with zoodles, eliminating water at every step helps! **To make this recipe ahead of time, prepare the zoodles and sauce and store them separately in the refrigerator until ready to serve. Then, reheat the sauce and zoodles separately and toss together once hot.
Nutrition
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Want More Paleo and Whole30 Zucchini Recipes? Try One of These!
Zucchini Pasta with Chicken and Scallion Avocado Sauce
Zucchini Noodle Breakfast Bake with Spicy Sausage
Zoodles with Spicy Shrimp Marinara
Zucchini Pasta with Chicken and Sun Dried Tomato Cream
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This dish was excellent. I used the coconut milk even though I was a little nervous about the flavor it would add, but it blended so well. My whole family enjoyed it. Next time I just need to make more.
This recipe is so good!!!
I left a message without rating. This recipe was so good. My husband went back for seconds.
Excellent! Really good, and super quick for a weeknight dinner.
What could be substituted for the coconut milk? Would almond milk work?
Amazing and super simple! We used hot Italian sausage which gave it the perfect kick. Thank you – this is a keeper.
Great recipe- easy and yummy
This one was another big hit with my husband,I also love it, thanks for the great cooking ideas
I love this recipe so easy to make and so delicious.
This is the first paleo/vegan (bf eats meat but is doing the whole 30, so he did the sausage separate) recipe I’ve gotten online that has been straight up AWESOME. He put more red pepper flakes in and we used butternut squash AND zucchini, but other than that, it was exactly the same and it was stellar. So good in fact that I’m leaving my first online recipe review. Ha!