Looking for a creamy, comforting, and protein-packed dinner that brings bold Italian flavor together with tender cabbage and rich alfredo sauce—without unnecessary carbs or gluten? This Keto Sausage Cabbage Casserole with Alfredo is exactly what you need. With its savory sausage layer, soft cabbage base, and silky keto alfredo topping, this one-dish wonder delivers all the richness of comfort food—while keeping it low-carb and keto-friendly.
Perfect for family dinners , meal prep , or when you’re craving something hearty but staying in ketosis, this easy-to-make recipe uses simple ingredients like ground sausage, almond flour, and dairy-free or traditional alfredo sauce to bring bold restaurant-style flavor into your kitchen. Whether you’re doing strict ketosis , following a low-carb lifestyle , or simply love creamy casseroles with depth and richness, this keto sausage cabbage casserole will quickly become a household favorite.
In this article, we’ll walk you through how to make this perfect keto sausage cabbage casserole from scratch , explore ingredient substitutions, offer serving ideas, and answer your most common questions. Let’s get started!
Why You’ll Love This Keto Sausage Cabbage Casserole
This isn’t just any old baked dish—it’s a savory, creamy, melt-in-your-mouth delight made with real ingredients that bring bold flavor and satisfying texture together beautifully—all in one pan!
Here’s why it stands out:
- 🍗 Savory sausage base : Loaded with natural spices and deep meaty flavor.
- 🥦 Low-carb veggie foundation : Uses cabbage for fiber and moisture without sugar spikes.
- 🧈 Creamy alfredo finish : Adds richness and silkiness without unnecessary carbs.
- 🍲 One-dish meal prep : Minimal cleanup, maximum convenience.
- ⏱️ Ready in under an hour
- 🧁 Great for batch cooking or freezer meals
- 🧼 Easy to customize : Add mushrooms, bacon, or extra cheese for variety
Whether you’re making it for yourself, your kids, or guests at a dinner party, this sausage cabbage casserole will quickly become a go-to comfort dish for any occasion.
Ingredients You’ll Need
For the Sausage Layer:
- 1 lb mild or spicy Italian sausage (casings removed)
- 1 tbsp olive oil or avocado oil
- 1 small onion, diced
- 2 cloves garlic, minced
- Salt and pepper to taste
Optional: A splash of chicken broth or white wine for extra depth
For the Cabbage Layer:
- 4 cups shredded green cabbage
- 1/2 cup heavy cream or full-fat coconut milk
- 1 tsp dried thyme or rosemary
- Salt and pepper to taste
Tip: Use red cabbage for color variation and added antioxidants
For the Alfredo Topping:
- 1/2 cup heavy cream or unsweetened almond milk
- 4 tbsp butter or ghee (or coconut oil for vegan option)
- 1 clove garlic, minced
- 1/2 cup grated Parmesan cheese (optional, for keto compliance)
- Salt and pepper to taste
Step-by-Step Instructions
Step 1: Cook the Sausage Mixture
Heat oil in a large skillet over medium-high heat.
Add onions and garlic; sauté for 2–3 minutes until softened.
Add ground sausage and cook until browned and cooked through.
Break apart with a spoon and drain excess fat if needed.
Pro Tip: Use lean sausage for better binding or fattier cuts for deeper flavor.
Step 2: Sauté the Cabbage
Add shredded cabbage directly to the skillet with the sausage mixture.
Toss well and add thyme, salt, and pepper.
Pour in heavy cream or coconut milk and let simmer gently for 6–8 minutes , until cabbage is tender and slightly wilted.
Note: Don’t overcook—cabbage should hold shape and not become mushy.
Step 3: Prepare the Alfredo Sauce
In a small saucepan over low heat, combine:
- Heavy cream or almond milk
- Butter or coconut oil
- Garlic
- Parmesan cheese (if using)
Simmer gently while stirring frequently until thickened slightly.
Season with salt and pepper to taste.
Optional: Mix in a few drops of lemon juice for brightness.
Step 4: Layer the Casserole
Transfer the sausage and cabbage mixture to a greased 9×9-inch baking dish or oven-safe skillet.
Smooth the top evenly across the pan.
Pour the warm alfredo sauce over the cabbage and gently spread to cover completely.
Step 5: Bake Until Golden and Bubbly
Place the dish in the preheated oven and bake at 375°F (190°C) for 15–20 minutes , or until the top is lightly golden and bubbly around the edges.
Let cool slightly before serving.
Step 6: Serve and Enjoy!
Serve warm straight from the dish or transfer to plates.
Pair with steamed broccoli, roasted asparagus, or a side salad for a complete keto meal.
Enjoy every creamy, savory bite of your Keto Sausage Cabbage Casserole with Alfredo !
Nutritional Information (Per Serving – Makes 6 Servings)
| Nutrient | Amount |
|---|---|
| Calories | ~250 kcal |
| Total Fat | ~20 g |
| Saturated Fat | ~8 g |
| Cholesterol | ~60 mg |
| Sodium | ~400 mg |
| Total Carbs | ~4 g |
| Dietary Fiber | ~1 g |
| Net Carbs | ~3 g |
| Protein | ~15 g |
Note: Values may vary based on exact measurements and optional add-ins.
Tips for the Best Keto Sausage Cabbage Casserole
- Use quality Italian sausage – Mild or spicy, both work great depending on preference.
- Don’t skip resting time – The flavors develop beautifully after cooling briefly.
- Add moisture as needed – If the cabbage seems dry, stir in a bit more cream or broth.
- Make ahead and store – Keeps best refrigerated in an airtight container.
- Double the batch for future meals – Great for lunch boxes or freezing later.
Variations & Customizations
Want to switch things up? Try these tasty variations:
Chicken Alfredo Style
Replace sausage with shredded cooked chicken or turkey for lighter version.
Zucchini Alfredo Casserole
Swap cabbage with spiralized zucchini for a juicier twist.
No-Bake Energy Bowl
Layer cold sausage and cabbage with sour cream and pickled vegetables.
Vegan Option
Use plant-based sausage, vegan butter, and cashew-based alfredo sauce.
Spicy Kick
Add diced jalapeños or hot sauce to the sausage layer for heat lovers.
Frequently Asked Questions (FAQ)
Is this truly keto-friendly?
Yes! With only ~3g net carbs per serving , it fits perfectly within a ketogenic lifestyle.
Can I use regular flour or sugar?
Not recommended—this recipe is naturally flourless and sweetener-free. Keep it clean!
How do I store leftovers?
Store cooled portions in an airtight container in the fridge for up to 4 days . Reheat in the oven or air fryer for best results.
What kind of alfredo sauce works best?
Homemade keto alfredo gives the richest flavor—store-bought options can be high in additives.
Can I freeze this casserole?
Yes! Cool completely, then transfer to a freezer-safe bag or container. Reheat at 350°F (175°C) for 15–20 minutes .
Why This Recipe Works So Well
This Keto Sausage Cabbage Casserole with Alfredo works because of its perfect balance of textures and bold flavors:
- The sausage delivers deep umami and protein power , keeping you full longer.
- The cabbage mimics pasta-like bulk while keeping it low-carb and keto-friendly.
- And the alfredo sauce ties everything together with a velvety finish and richness.
It’s the kind of dish that makes eating clean feel indulgent—because it tastes so good.
Serving Suggestions
Looking for creative ways to serve your keto sausage cabbage casserole beyond just a plate? Here are some ideas:
In Wraps
Wrap in large lettuce leaves or collard greens for handheld eats.
Over Greens
Top arugula or spinach with warm casserole for a heartier salad.
With Dipping Sauces
Try chipotle mayo, ranch, or garlic aioli for extra flair.
At a Party
Cut into squares and arrange on a platter with toothpicks for appetizer bites.
As Leftovers
Crumble over mashed cauliflower or mix with eggs for balanced lunches.
Health Benefits of Key Ingredients
Let’s take a quick look at the health benefits of what makes this dish special:
Italian Sausage
High in iron and B vitamins—supports energy and muscle maintenance.
Green Cabbage
Rich in fiber and vitamin K—great for digestion and bone strength.
Butter / Cream
Provides MCTs and fat-soluble vitamins—important for hormone production and brain function.
Even though this is a comfort-style dish, it’s packed with nutrients that make it more than just a treat—it’s a smart addition to your balanced lifestyle when enjoyed mindfully.
Final Thoughts: A Must-Try Comfort Dish for Alfredo Lovers
This Keto Sausage Cabbage Casserole with Alfredo proves that going low-carb doesn’t mean missing out on bold, comforting flavors. With its soft cabbage, savory meat base, and creamy alfredo finish, it’s the kind of dish that turns a simple casserole into something magical.
Whether you’re new to keto, looking for a fast family dinner idea, or want to impress with homemade flair, this casserole deserves a spot in your kitchen. It’s easy to make, customizable, and loved by kids and adults alike.
So go ahead—whip up a batch, share it with family, or savor it solo. Either way, you’re treating yourself to something worth celebrating.
Print
Keto Sausage Cabbage Casserole with Alfredo – Creamy, Hearty & Perfectly Low-Carb!
- Total Time: 55 mins
Description
A creamy, savory blend of sausage, cabbage, and cheese delights!
Ingredients
1 medium head of cabbage, 1 medium yellow onion, 4 garlic cloves, minced, 1/4 cup salted butter (half a stick) + 2 tablespoons, divided, 2 – 8 oz. blocks full-fat cream cheese, 1/2 cup full-fat sour cream, 1/4 cup heavy whipping cream, 1/2 teaspoon salt, 1/2 teaspoon pepper, 1 teaspoon garlic powder, juice from 1 large lemon, 1 cup parmesan cheese, shaved or shredded, 1 pound Italian sausage links, 2 tablespoons parsley, chopped, to garnish
Instructions
1. Preheat oven to 400 degrees.
2. Slice cabbage into thin strips. Discard large stem pieces. Place in a 9×13-inch baking dish.
3. Slice onion into thin strips and add to the baking dish. Mince garlic and add to the baking dish with the cabbage and onion. Lightly toss to combine.
4. Cut butter into pats and spread evenly over the cabbage. Cut cream cheese into cubes and spread over cabbage.
5. Dollop sour cream evenly over the cabbage. Pour the heavy whipping cream over the cabbage mixture.
6. Sprinkle the salt, pepper, and garlic powder over the cabbage mixture.
7. Bake cabbage for 35 to 40 minutes, until just starting to brown.
8. While the cabbage is baking, cook the sausage links. Melt 2 tablespoons butter in a skillet over medium heat. Place sausages in skillet and brown all sides until fully cooked, about 15 to 20 minutes. Remove from heat and let rest for a few minutes, then slice each sausage link into 6 pieces.
9. Once the cabbage is done baking, remove it from the oven and mix in the lemon juice and parmesan cheese. Top with the sausage pieces and gently mix them in with the cabbage. Place the baking dish back in the oven and bake for another 10 minutes to melt the cheese.
10. While the cheese is melting, chop the fresh parsley. When done, remove the dish from the oven and garnish it with parsley. Enjoy!
- Prep Time: 10 mins
- Cook Time: 45 mins
Nutrition
- Serving Size: 8
- Calories: 538
- Fat: 43.6g
- Carbohydrates: 13.8g
- Protein: 20.9g