This keto cauliflower pizza casserole combines the flavors of pepperoni pizza with the creamy comfort of a casserole. This recipe brings casseroles to a whole new level!
Instead of using carb-loaded pasta as a base, we use steamed cauliflower. Not a cauliflower fan? Try the recipe anyway. It doesn’t taste one bit like cauliflower. Instead, it’s more like macaroni and cheese meets pepperoni pizza. The sauce is rich and creamy with notes of tomato, garlic, basil and oregano. The red pepper flakes add just a little bit of heat and complexity. Add in layers of pepperoni and gooey mozzarella cheese, and this recipe becomes comfort food nirvana.
Just because it’s delicious doesn’t mean this recipe is difficult. This casserole is easy to put together and makes an ideal weekday dinner. Don’t worry if you have extra because it tastes even better the second day. Just cover and refrigerate the unused portion. To reheat, take out the desired amount and reheat with the method of your choice.
When making this casserole, the cauliflower is steamed lightly before the dish is assembled. Don’t over-cook it because it will cook a bit more in the oven. You can save time by beginning the sauce while the cauliflower steams. After the sauce and the cauliflower are finished, assembling the casserole is a snap. Once it’s put together, pop it in the oven and relax while the oven bakes it into gooey goodness.
Yields 9 servings of Keto Cauliflower Pizza Casserole.
The Preparation
- 588 grams cauliflower, cut into florets
- 1 tablespoon butter
- 1 medium yellow onion, diced
- 1 teaspoon fresh garlic, crushed
- 2 tablespoons balsamic vinegar
- 1 cup heavy whipping cream
- 6 ounces cream cheese, cubed
- 3 tablespoons tomato paste
- 3 cups mozzarella cheese, divided
- 1/2 teaspoon dried oregano
- 1 tablespoon fresh basil
- 1 teaspoon sea salt
- 1/4 teaspoon black pepper
- 3 ounces pepperoni
- crushed red pepper flakes, to taste
The Execution
1. Preheat oven to 350º Fahrenheit. Spray 9 inch square glass pan with an oil of choice
2. Steam cauliflower for 10-13 minutes or until crisp but tender. Do not overcook. Remove from the heat and set aside.
3. Heat a large skillet over medium heat. Add butter.
4. When the butter stops bubbling, add the onion and cook, stirring occasionally until edges are just starting to brown.
5. Add garlic and cook, stirring constantly for one minute.
6. Pour the balsamic vinegar into the onion and garlic mixture. Simmer over medium heat, scraping up any browned bits, until mixture has a syrupy consistency.
7. Add in cream, cream cheese, and tomato paste. Stir until mixture is smooth. Stir in one cup of mozzarella cheese (reserving the other two cups).
8. Simmer, stirring frequently, until mixture has a thick, creamy consistency. Add oregano, basil, red pepper flakes, salt and pepper. Taste and adjust seasoning if desired. Remove from heat.
9. In the prepared pan, spread half of the steamed cauliflower. Arrange half of the pepperoni slices over the cauliflower. Sprinkle one cup of mozzarella (reserving the third cup). Layer the rest of the cauliflower and pepperoni slices (but not the mozzarella) in a similar manner. Pour the cream sauce evenly over the layers. Sprinkle with the remaining cup of mozzarella.
10. Bake in preheated oven for about 20 to 30 minutes or until casserole is bubbly and cheese is lightly browned. Cool 5 to 10 minutes before serving.
This makes a total of 9 servings of Keto Cauliflower Pizza Casserole. Each serving comes out to be 354 calories, 30.3g fats, 6.1g net carbs, and 13.6g protein.
| NUTRITION | CALORIES | FAT | CARBS | FIBER | NET CARBS | PROTEIN |
| 588 gram cauliflower | 135 | 2.9 | 24.1 | 13.5 | 10.6 | 10.6 |
| 1 tablespoon butter | 102 | 11.5 | 0 | 0 | 0 | 0.1 |
| 1 medium yellow onion | 41 | 0.2 | 9.5 | 1.3 | 8.2 | 1.3 |
| 1 teaspoon fresh garlic | 4 | 0 | 0.9 | 0.1 | 0.9 | 0.2 |
| 2 tablespoon balsamic vinegar | 28 | 0 | 5.4 | 0 | 5.4 | 0.2 |
| 1 cup heavy whipping cream | 809 | 85.9 | 6.5 | 0 | 6.5 | 6.8 |
| 6 ounce cream cheese | 582 | 57.8 | 7 | 0 | 7 | 10.5 |
| 3 tablespoon tomato paste | 40 | 0.2 | 9.3 | 2 | 7.3 | 2.1 |
| 3 cup mozzarella cheese | 1008 | 75.1 | 7.4 | 0 | 7.4 | 74.5 |
| 1/2 teaspoon dried oregano | 2 | 0 | 0.5 | 0.3 | 0.2 | 0.1 |
| 1 tablespoon fresh basil | 0 | 0 | 0 | 0 | 0 | 0.1 |
| 1 teaspoon sea salt | 0 | 0 | 0 | 0 | 0 | 0 |
| 1/4 teaspoon black pepper | 1 | 0 | 0.3 | 0.1 | 0.2 | 0.1 |
| 3 ounce pepperoni | 429 | 39.4 | 1 | 0 | 1 | 16.4 |
| — crushed red pepper flakes | 0 | 0 | 0 | 0 | 0 | 0 |
| Totals | 3182 | 273.1 | 72.1 | 17.4 | 54.7 | 122.7 |
| Per Serving (/9) | 354 | 30.3 | 8 | 1.9 | 6.1 | 13.6 |

Keto Cauliflower Pizza Casserole
Ingredients
- 588 gram cauliflower cut into florets
- 1 tablespoon butter
- 1 medium yellow onion diced
- 1 teaspoon fresh garlic crushed
- 2 tablespoon balsamic vinegar
- 1 cup heavy whipping cream
- 6 ounce cream cheese cubed
- 3 tablespoon tomato paste
- 3 cup mozzarella cheese divided
- ½ teaspoon dried oregano
- 1 tablespoon fresh basil
- 1 teaspoon sea salt
- ¼ teaspoon black pepper
- 3 ounce pepperoni
- crushed red pepper flakes to taste
Instructions
- Preheat oven to 350F. Spray a casserole dish with your oil of choice. Steam cauliflower for 10-13 minutes or until crisp but tender. Do not overcook. Remove from the heat and set aside.
- Heat a large skillet over medium heat. Add butter.
- When the butter stops bubbling, add the onion and cook, occasionally stirring until edges are just starting to brown. Add garlic and cook, constantly stirring for one minute.
- Pour the balsamic vinegar into the onion and garlic mixture. Simmer over medium heat, scraping up any browned bits, until mixture has a syrupy consistency.
- Add in cream, cream cheese, and tomato paste. Stir until mixture is smooth. Stir in one third of the mozzarella cheese (reserving the other two thirds).
- Simmer, frequently stirring, until mixture has a thick, creamy consistency. Add oregano, basil, red pepper flakes, salt and pepper. Taste and adjust seasoning if desired. Remove from heat.
- In the prepared pan, spread half of the steamed cauliflower. Arrange half of the pepperoni slices over the cauliflower. Sprinkle one half of the remaining mozzarella (reserving the remainder). Layer the rest of the cauliflower and pepperoni slices (but not the mozzarella) in a similar manner. Pour the cream sauce evenly over the layers. Sprinkle with the remaining mozzarella.
- Bake in preheated oven for about 20 to 30 minutes or until casserole is bubbly and cheese is lightly browned. Cool 5 to 10 minutes before serving.










This one was reeeeeediculous, and by ridiculous, I mean amazing. 🙂
Really glad I found this website… quite excited to try this one out!
Made this last night for supper. Absolutely delicious. My husband requested 3 times that I could make it again in near future.
Mary-Ann that’s awesome! I know that’s such a great feeling, I’m so glad your family enjoyed it.
My husband highly approved of this. In fact, he plated and ate one serving, then asked me to warm up another serving! I’m about to have it for lunch. Thank you for such a wonderful site – I am learning so much and all the recipes I’ve tried so far have been winners.
That’s great Adrienne! It’s so fun when my husband loves these foods too. I’m happy you’re enjoying the recipes!
Legendary!! Taking out the oven in 5 minutes from now! Made it the other night and our “I won’t eat this cr*p unless it is loaded with sugar/covered in breadcrumbs/drowned in ketchup, maple syrup or nutella” 5-year old devoured it!! Thanks for ALL your amazing recipes!!
Hahah! I have a 3 year old so I know the feeling -___-; Mine loves the pizza crust from keto pizzas.
“It tastes even better the second day.” Truer words were never written. I didn’t think it would be possible for it to taste better! This casserole is amazing, particularly the cream sauce. I’m dreaming up other ways to use it in the future.
Thanks Lesley!
This was incredibly rich and decadent. My husband and 5 year old daughter LOVED it. Will make again. I might try with sausage next time. Has anyone tried it with sausage?
Oh man, when my kid loves something full of vegetables I’m like the cat that ate the canary. xD
I know it’s been a year. But how was it with sausage?
Even better with sausage, in my opinion. I almost always make it with sausage now.
I made this and it was amazing!! Loved it. Trying another recipe from here this weekend : )
Really happy to hear, Lisa!
Could I use hamburger or sliced ham instead of pepperoni?
Yeah, of course!
Just wanted to say I absolutely adore this recipe! Thank you so much for sharing it!
Has anyone tried to prep during the day, refrigerate & pop into the oven before serving? Any reason not to?
I see the meal is split into 9 servings. Can anyone else confirm that the serving size is enough for a meal? I was hoping to make enough for my lunch for the week (I’ve been eating 2 chicken breasts and a cup of mixed veggies) but am unsure if the serving size will be enough to be filling. It’s hard to tell from the photos how big it actually is, and the carbs are a bit higher than what I’m comfortable with.
58 grams net carbs is for the whole recipe. It comes out to under 7 gr net carbs per serving, so that is pretty good. I’m trying to stay under 25g net carbs per day, so this fits in well. Not sure if I can stop at one serving though! Maybe add ½ avocado to your lunch with this?
This was delicious! Even hubby loved it! I never did mention the cauliflower in it, though!
I’ve been having a overwhelming craving for Pizza and was strongly considering cheating on my diet to give in to the temptation. I made this last night and holy smokes was it good and it satisfied my craving for Pizza. Thanks so much for this recipe.
I’m glad to hear that Joe!
I love pizza too! Making this tonight. I also take about 1.5 cups shredded mozzarella and melt in a frying pan until the one side is a light brown, flip and do the same on the other side. Spread some sauce on the top, more mozzarella and pepperoni and put under the broiler until the pepperoni is crisped a little and bubbling.
Made this and it was really delicious. Nice side dish, too.
Mmmmmm. I made two ot these tonight. One with pepperoni and one with sausage. I plan to put them in individual containers and freeze some for later. This is absolutely delish and totally cured my craving for something decadent like pizza. Thank you!
Thank you Malinda! Sausage sounds like a great option.
Great recipe! Made it without the pepperoni so I could share it. I thought my sauce was too thick at first, but it loosened up in the oven. Reheated perfectly. It was a big hit and not overly time consuming.
i really wish you would specify the serving SIZE.
All of the serving sizes we use are based on volume we got from the recipes on what we think an average serving would be. They are completely generalized and don’t necessarily need to be followed. Serving sizes in general can change based on the persons needs and macros. You can always take the macros of the full recipe and divide them into the amount you need to suit your macros/dietary needs.
This is one of my favorite go to quick meals. I have even made the sauce and put it on fathead pizza. It’s so delicious.
Oh my gosh that’s a brilliant idea!
I see it makes 9 servings, what size is 1 serving? A cup?
Serving sizes are generalized based on how many calories are in the whole recipe and how much volume was produced by the recipe. There is no set in stone serving size – it is all up to you. Some people prefer fasting and eating 1-2 meals a day, some people like to spread their meals out.
I’d recommend running your macros through our keto calculator (https://www.ruled.me/keto-calculator/) and adjusting from there.
This is by far the best low carb recipe I have ever tried! It tastes just like pizza! 🙂 The only modification I made was to substitute the pepperoni for low-carb veggies (mushrooms, black olives and green peppers) for a healthier vegetarian casserole. I will definitely be making this again and can’t wait to try other recipes on this site. Thanks! 🙂
could one sub cauliflower rice for the florets?
This has become a staple in our house. Every other week. So good
I made this tonight— it’s excellent!!!
I really liked this! We agreed that it tastes even better the next day! I did use a jar of low carb sauce that I needed to use up, and then just added the cream cheese to it and onions, etc. No cream. Will make again!
Really happy you guys enjoyed it! I 100% agree with you that it makes for some amazing leftovers, too 😁
This is my favorite Keto casserole recipe so far! It’s delicious!
Crazy delicious! I'm going to try the sauce on meatballs. Oh yeah, don't skip the balsamic.