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Paleo Spaghetti Squash & Meatball Casserole Recipe |

Spaghetti Squash & Meatball Casserole

  • Author: Chelsea @
  • Prep Time: 1 hour
  • Cook Time: 40 minutes
  • Total Time: 1 hour 40 minutes
  • Yield: 6-8 servings 1x
  • Category: Entree
  • Method: baked



For the Spaghetti Squash & Sauce

  • 1 large spaghetti squash (for 8 cups cooked squash)
  • 1 teaspoon extra virgin olive oil
  • 1 medium onion, diced (1/2 cup)
  • 2 large cloves garlic, minced (1 tablespoon)
  • 1 15 ounce can tomato sauce
  • 1/4 cup tomato paste
  • 2 tablespoons dried basil
  • 1 tablespoons dried parsley
  • 1 teaspoon dried oregano
  • 1/2 teaspoon salt
  • 1/2 teaspoon ground black pepper

For the Meatballs

  • 1 pound ground beef
  • 1 pound ground pork or ground turkey
  • 2 tablespoons almond flour
  • 1 teaspoon salt
  • 1/2 tablespoon basil
  • 1/2 tablespoon parsley
  • 1 teaspoon dried oregano


  1. Preheat the oven to 400 degrees F.
  2. Carefully cut the spaghetti squash in half lengthwise. Remove the seeds. Place the squash cut side down on a rimmed baking sheet. Cook for 45 minutes or until squash is tender. Use a fork to separate out the spaghetti squash strands from the peel. Let cool enough to handle. Measure out 8 cups spaghetti squash for the recipe (give or take - a little more or a little less won't hurt anyone).
  3. Reduce the oven to 350 degrees F.
  4. Heat the olive oil in a skillet over medium heat. Add the onion and garlic, sautéing for about 5 minutes or until onion has softened and turned translucent. Remove from heat.
  5. In a large bowl, mix cooked spaghetti squash, sautéed onion and garlic, tomato sauce, tomato paste, basil, parsley, oregano, salt, and pepper until the spaghetti squash is coated evenly.. Place in a large 9x13 casserole dish.
  6. In a separate medium bowl, mix the meatball ingredients - be careful not to over-mix, or the meatballs will turn out tough! Form meatballs and arrange in rows across spaghetti squash and sauce mixture. Bake for 40 minutes or until meatballs are cooked through. Garnish the finished casserole with some fresh parsley, if desired. This casserole will keep in a tightly sealed container in the fridge for up to a week. Serve warm.

Keywords: spaghetti squash meatball casserole, paleo casserole, meatball casserole, spaghetti squash casserole