Paleo Recipe Review- Creamy Tomato Basil Spaghetti Squash

Y’all this was SO good… and I made it! 😜

I haven’t eaten spaghetti squash much so I wasn’t sure what to expect but it didn’t matter. The sauce is what made this.

So far, this is our favorite by far. Chad and I both loved it and I plan to add this to our regular rotation. It is so flavorful and doesn’t make me miss pasta.

The recipe came from Paleo Running Mama. She said she also has a popular Chicken Pesto Spaghetti Squash recipe that I plan to try this week.

It is also Whole 30 and Keto compliant if you’re into that.

Try it and let me know what you think!

Sausage Tomato Basil Spaghetti Squash

Prep Time: 10 minutes

Cook Time: 45 minutes

Total Time: 55 minutes

Course: Dinner/Lunch

Cuisine: keto, Paleo, Whole30

Servings: 8


  • 1 med spaghetti squash
  • olive oil and salt for roasting squash
  • 1 Tbsp ghee or coconut oil
  • 1 lb sweet Italian sausage or any Whole30 compliant sausage
  • 1/2 tsp crushed red pepper or to taste
  • 1 medium onion chopped
  • 4 cloves garlic minced
  • cup fresh basil torn
  • 15 oz can diced tomatoes fire roasted, drained
  • 1/2 cup coconut cream or full fat coconut milk
  • 1/4 tsp sea salt
  • Parsley for garnish
  • Extra red pepper flakes salt, and pepper to suit your taste


roast squash:

  1. Preheat your oven to 435 degrees. Cut the squash in half, lengthwise, and scoop out the seeds and strings. Brush inside with olive oil and sprinkle with sea salt.
  2. Place face down on a foil lined baking sheet, and roast in the preheated oven for 25 mins or until the top of squash is just soft enough to push in with your finger. The time will vary depending on the size of the squash.

make the sauce:

  1. Meanwhile, heat a large skillet over medium heat, once heated, add the cooking fat.
  2. Remove casings from sausage and crumble into the skillet, then sprinkle red pepper flakes over sausage. Use a spatula to break apart the sausage as it cooks. Cook 2-3 mins or until browned and crumbled.
  3. Once sausage is browned, add onions and stir, cook about 2 minutes until softened, then add garlic and continue to cook another minute, stirring.
  4. Once garlic is softened, add in the tomatoes, coconut cream or milk, salt and Italian seasoning or fresh herbs. Stir to combine everything, then bring to a boil. Lower heat and allow mixture to simmer 2-3 minutes.

assemble and bake:

  1. Once squash is done, lower oven temp to 400 F. Allow squash to cool long enough to handle. Use a fork to remove the “spaghetti” by scraping squash lengthwise.

  2. In a large casserole dish, layer the spaghetti with the sausage mixture to evenly mix. Bake in the preheated oven 15-20 mins or until heated through. Enjoy!


Calories: 317kcal
Fat: 25g
Saturated fat: 12g
Cholesterol: 47mg
Sodium: 514mg
Potassium: 454mg
Carbohydrates: 13g
Fiber: 3g
Sugar: 5g
Protein: 10g
Vitamin A: 4.3%
Vitamin C: 12.8%
Calcium: 6.9%
Iron: 11.8%

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