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Keto Meatball Pasta Bake Recipe

Louise | November 6
Keto Meatball Pasta Bake Recipe #keto

This Keto meatball pasta bake may require a little bit of prep work, but the results are well worth the effort. This zucchini “pasta” bake has everything you could possibly want; juicy meatballs, tangy tomatoes, salty pepperoni, and tender Keto noodles. Make it on the weekend for the perfect Italian-inspired Sunday dinner, or recruit some help in the kitchen and make it on a weekday. With a couple of extra hands, meatballs and zucchini noodle are a breeze to make. Plus, food, family, and friends so together like spaghetti and meatballs!

The Making of a Keto-Friendly Meatball Pasta Bake

A pasta bake has several different components, and some are already Keto but many are not. Read on to find out how we make this meatball pasta bake keto-friendly and what it does (and doesn’t) have in in common with the typical pasta bake.

  • Meatballs – Meatballs are the perfect addition to a Keto pasta dish at first glance, however, many standard meatball recipes include bread or breadcrumbs. Our low-carb meatballs omit this non-Keto-friendly ingredient, relying solely on egg for binding.
  • Pepperoni – Already Keto, but do be mindful of any unnecessary additives or preservatives.
  • Tomatoes and onions – Already Keto, no problems here.
  • Tomato sauce – Most store-bought tomato sauces have very high levels of added sugar, which can make it challenging to find Keto-friendly, premade tomato sauce. One way to get around this is to make your own sauce so you know exactly how sugar has been added, zero.
  • Flavorings – Basil, parsley, garlic, salt, and pepper; already Keto, no issues.
  • Noodles – Definitely not naturally Keto! This recipe uses zucchini noodles in place of standard wheat noodles but there are other options for low-carb pasta substitutes.
  • Garnish – This recipe uses basil leaves. If you are not avoiding dairy, cheese is also a traditional and tasty option.

3 Tips for the Perfect Zucchini Noodles

  1. Get the right equipment: A vegetable peeler works fine in a pinch but if you are planning on making a lot of zucchini noodles on a regular basis, investing in a countertop spiralizer will make the process much faster and easier.
  2. Don’t overcook: overcooked zucchini noodles will turn to mush even faster than wheat pasta. Keep a close eye on your noodles as they cook to avoid any mushy surprises.
  3. Get rid of some water before cooking: If you have had watery noodles in the past, one way to avoid repeating the problem is to salt the uncooked noodles and let them drain for 30 minutes before rinsing very well and proceeding with the recipe as written.

More Keto “Pasta” Recipes

Bolognese on the brain? Check out more Keto Italian recipes!

Keto Meatball Pasta Bake Recipe #keto

Keto Meatball Pasta Bake Recipe #keto

Keto Meatball Pasta Bake Recipe

  • Author: Louise Hendon
  • Prep Time: 15 minutes
  • Cook Time: 45 minutes
  • Total Time: 1 hour
  • Yield: 8 servings 1x
  • Category: Dinner, Entrée
  • Cuisine: American


A Keto casserole with an Italian flair.


For the meatballs –

  • 2 lbs (900 g) of ground beef
  • 1 cup (32 g) fresh basil leaves
  • 1 cup (32 g) fresh parsley
  • 1 medium egg
  • Salt and pepper, to taste
  • 1/4 cup (60 ml) avocado oil, to cook with

For the bake –

  • 6 oz of pepperoni or salami slices, diced
  • 1 can (400 g) diced tomatoes
  • 1 medium onion, diced
  • 1/2 400g-can of tomato sauce
  • 3 cloves of garlic, finely diced or minced
  • Salt and pepper, to taste

For the pasta –

  • 2 zucchinis, spiralized or shredded or peeled into long noodle-like strands
  • Extra basil leaves, for garnish


  1. Preheat oven to 350 F (175 C).
  2. Mix the meatball ingredients together and form small balls.  Brown the meatballs in a frying pan with the avocado oil.
  3. Mix the bake ingredients together in a bowl.
  4. Place the meatballs into a baking dish and pour the bake sauce in.
  5. Bake for 30 minutes.
  6. Then carefully stir in the zucchini noodles, let sit for 5 minutes, and serve.


All nutritional data are estimated and based on per serving amounts.

Net Carbs: 5 g


  • Calories: 508
  • Sugar: 4 g
  • Fat: 40 g
  • Carbohydrates: 7 g
  • Fiber: 2 g
  • Protein: 25 g

Louise co-founded Louise's Foods, Paleo Living Magazine, Nourishing Brands, & CoBionic. She has considerable research experience but enjoys creating products and articles that help move people just a little bit closer toward a healthy life they love.