Paleo Spaghetti Squash & Meatball Casserole |

Spaghetti Squash & Meatball Casserole

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Spaghetti squash is just begging to be used as its namesake, isn’t it? That’s why this Paleo Spaghetti Squash & Meatball Casserole Recipe needs to get made, stat.

If you can’t imagine spaghetti without plump meatballs nestled among the strands, you probably immediately thought of spaghetti and meatballs when you first heard of spaghetti squash. (Me, too). I quickly learned that spaghetti squash isn’t literally a squash that tastes like spaghetti and meatballs, and it’s much more versatile than that. (See, for example, spaghetti squash chow mein).

Still, this simple gluten free recipe has been a long time comin’, and I’m glad it’s finally ready to share on the DoYouEvenPaleo!

Spaghetti Squash & Meatball Casserole Recipe |

Legit conversation that happened with my spouse the first time I made this spaghetti squash & meatball casserole:

Him: “I’m surprised you’re eating this!”

Me: “Why? It’s good.”

Him: “But you haven’t eaten pasta in… years.”

Me: “… This isn’t pasta.”

Him: “What? No way. What is it, then?”

Apparently my husband didn’t really get spaghetti squash until that night. But, nonetheless, he adored this casserole even though he’s a squash hater.

Paleo Spaghetti Squash & Meatball Casserole Recipe |

Isn’t it a little weird that spaghetti squash is the only squash that gourd-haters seem to like? Meanwhile, I’d rather be inhaling a feast of roasted kabocha squash. Awwww yeah.

Not to say I don’t like spaghetti squash. I just don’t bother with it most of the time.

But when you’re prepping meatballs and the thought for a big, hearty, cook-once-and-eat-for-the-week casserole pops into your head, you’ve got to pursue that shit.Spaghetti Squash & Meatball Casserole Recipe |

Frankly. casseroles are my favorite use for spaghetti squash. The stringy gourd makes an excellent base for all types of combinations, like Chicken Bacon Ranch. Unlike other squashes, spaghetti squash is pretty neutral, so the other add-ins impart the flavor.

Moving on. Let’s talk about the sauce. One recurring theme of this blog is no bland food. I made this casserole a number of times, tweaking the sauce and meatballs until I hit on the right amount of spice. Because seriously, spaghetti sauce shouldn’t taste like tomato sauce. You’ve got to have notes of basil, oregano, and parsley. Ah, now that’s a good marinara!

Paleo Spaghetti Squash & Meatball Casserole

Spaghetti Squash & Meatball Casserole Recipe |

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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 9×13 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


Paleo Spaghetti Squash & Meatball Casserole Recipe Pin |


I'm Chelsea, the author behind Do You Even Paleo! I believe life should be full of flavor. I enjoy creating recipes that are nourishing, flavorful, and satisfying. When not experimenting in the kitchen, I usually have a camera, barbell, or mug of coffee in hand. My posts may include affiliate links, which means if you click through a purchase something, I make a small commission at no cost to you. It helps me fuel my coffee habit and pay rent!

7 thoughts to “Spaghetti Squash & Meatball Casserole”

    1. Hmm. I think you could substitute coconut flour, but I’d be a little afraid it would soak up too much moisture. If I were making the casserole again and ran out of almond flour, I’d probably just leave it out entirely! Let me know what you do and how it works!

  1. you already know that I’m going to kick it up a little with a home grown serrano pepper !!! … just a whole one used when cooking the meatballs … imparts just a little tang , dontcha know !!!

  2. I make meatballs for my freezer and would like to be able to use them for the top of this casserole. They’ve already been cooked. At what point and with what prep (beyond defrosting) would you advise adding the mean balls?


    1. Hmmm. I’d probably start the spaghetti squash/sauce mixture on its own in the oven, then add the defrosted meatballs after about 30 minutes. Then finish it all off for another 10 minutes or longer to warm up the meatballs. Hope that works!

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