Paleo Sausage Cauliflower Casserole

After a long week, I find that I want to turn to pizza on Friday nights because it’s quick and delicious, and I am ready to relax at home and basically just veg out. With my healthy lifestyle mission, I instead turned to Pinterest for some easy paleo dinner ideas this past Friday and stumbled across some variations of this recipe, which I molded into something of my own and it was incredibly tasty and far more satisfying than a pizza. (Although sometimes you do just have to eat pizza.) I guarantee I’ll be adding this one to the meal rotation. It also makes plenty and would easily serve a small family, I’d say you could count on 4 full servings, plus some – which made for great leftovers when reheated in the oven. I hope you enjoy!

Not photographed would be the cauliflower preparation. I started out by cutting a head of  cauliflower into florets, and then blanching them in boiling water for 3 minutes, followed by removing and rinsing with cold water to stop the cooking process. I just set them aside while I moved on to everything else, and they still ended up with a slight crunch after the meal was completely done Рbut they were able to soak all of the flavors up which I thought was perfect in terms of texture and taste. If you prefer softer cauliflower, you could probably let them boil for about 4 minutes instead.

For the sausage, I used 12 oz. of uncured beef sausage, sliced. This would certainly be enough, but I wanted to add a bit of a kick, so I also use half a pound of hot Italian sausage, which added some nice heat. I would suggest you vary to your specific tastes, I think you could reasonably use just about any sausage option for this dish.


After browning the sausage in a bit of coconut oil, I added in the diced onion, garlic, fresh thyme, 3 fresh basil leaves (torn into pieces), and just a bit of dried oregano. I would suggest you adjust the basil to your liking, it can add a bit of sweetness and the 3 leaves worked quite well without overpowering the dish.


Once the onions were cooked until translucent, about 4-5 minutes, I added a can of diced San Marzano tomatoes and allowed this to cook with the sausage mixture for about 5 minutes. I had a 28 oz. can, but didn’t quite use the whole thing. I added about 3/4 of the can, along with the liquids. Next time, I’ll likely drain out some of the liquid from the can first, because there was a bit more liquid at the bottom of the casserole than I preferred, but you do still need some for the cauliflower to soak up. I’d say to play with this for your specific tastes, the extra liquid didn’t affect the taste or texture at all, I just had to drain a bit of it off before storing for leftovers.


After all of the above, I gently tossed in the cauliflower, poured the entire mixture into a 9×13 baking dish and sprinkled almond flour mixed with just a bit of Italian seasoning on top. After baking for about 30 minutes on 350 degrees F, I ran the boiler for a minute or so, watching carefully because I just wanted a bit more browning on the almond flour topping – not a burn. The result was absolutely delicious – and not bad to look at, either!


Paleo Sausage Cauliflower Casserole


  • 1 head of cauliflower, cut into florets
  • 12 oz of uncured beef sausage (or sausage of your choice), sliced (I also added 8 oz of hot Italian sausage, you can be flexible here)
  • 1 tbsp coconut oil
  • 5 springs of thyme, remove use the leaves and toss the stems
  • 3 fresh basil leaves, tear into pieces
  • 1/2 tsp dried oregano
  • 4 cloves of garlic, minced
  • 1 medium yellow onion, diced
  • 1 28 oz can of diced San Marzano tomatoes
  • 1/2 cup almond flour (almond meal works best, as opposed to finely ground)
  • 1/2 tsp Italian seasoning
  • Salt and pepper to taste


  1. Preheat the oven to 350 degrees F.
  2. Bring a pot of water to boil, then add the cauliflower florets and boil for 3 minutes. (A minute longer if you prefer softer cauliflower) Remove and drain, rinsing under cold water in order to stop the cooking process, then set aside.
  3. Stir in the 1/2 tsp of Italian seasoning into the 1/2 cup of almond flour and set aside.
  4. In a large skillet or dutch oven, heat the coconut oil on medium heat. Add the sausage of your choosing and cook until browned, stirring often.
  5. Stir in the onion, garlic, thyme, basil and oregano. Stir often and cook until the onions are translucent, about 4-5 minutes.
  6. Add the tomatoes (you can add the whole can, or a bit less depending on your preference) and cook for an additional 5 minutes, stirring periodically.
  7. Turn off the heat and slowly add the cauliflower to the sausage mixture and gently stir together. Transfer to a 9×13 baking dish, sprinkle the top with the almond mixture and bake at 350 degrees F for minutes. You an also broil for 1-2 minutes after the baking process to brown the top a bit more, if you prefer.


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