This quintessential Italian comfort food just got a healthy makeover! Sausage and Peppers can fit into almost any diet – just depends on how you serve ’em! Dish up Italian sausage (sweet or spicy) with bell peppers, onions, and roasted tomatoes over creamy cauliflower puree for a hearty family dinner that’s keto and Whole30 friendly.

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Ask ten Italian-Americans how they make Sausage and Peppers and you’re getting ten different answers. The only thing they’ll agree on is that the dish must include 1) sausage and 2) peppers. However, do not expect them to agree on what specific sausage or peppers must be included.
Also, do not expect them to agree on how either the sausage and/or the peppers are cooked. Or whether they’re cooked together or separately using different methods. Don’t ask about grills vs. sheet pans vs. skillets vs. whatever is going on here. Do not expect a straight answer on how to serve it either. Might be on a hoagie roll, might be over pasta. Might be neither, might be both.
If you’re wondering about onions, maybe they’re there, maybe not; maybe they’re yellow, maybe they’re red. Seasoning? You think it’s safe to assume any S&P recipe calls for garlic, but assume nothing! Some people don’t add garlic because they use sausage loaded with the stuff. If they do add it, it could be whole cloves, minced, powdered, or all three. Just accept there are simultaneously no right answers and yet, only one right answer.
Look, I know some of you are Italian and you’re here just so you can roll your eyes, scoff, and say “this isn’t how you make sausage and peppers.” I know this because that’s what I do when I see other people’s recipes. But for those of you who don’t come fully loaded with your own bespoke blend of sausage, peppers, and 11 herbs & spices…enjoy!
Healthy Sausage and Peppers
With no added sugar (and no starchy base), this dish fits the bill for most Keto, Whole30, and grain or gluten free diets. Be mindful if you’re counting carbs, though! Peppers push the limit so you may want to “save up” and splurge.
Tips for Making Sausage and Peppers Perfectly
- Fire roasted tomatoes make the sauce taste slow simmered.
- While it won’t make or break the recipe, a touch of fresh basil is definitely the “cherry on top.”
- Feel free to use either sweet (mild) or hot italian sausage.
- Make sure to brown your sausage first to hold the shape.
How to Serve Sausage and Peppers
- Cauliflower Puree: skip the cheese if you’re dairy free on on a Whole30; feel free to add a splash of cashew milk for a creamier finish.
- Mashed Potatoes: if you’re Whole30 or paleo, be sure to use a compliant recipe.
- Polenta or Pasta
- Hoagie Rolls
- Nothing at all: if you want to keep it super low carb, you can always eat the sausage and peppers alone; for a little extra fat, top with a dollop of ricotta cheese.
More Healthy Italian Recipes
- Italian Sausage Stuffed Zucchini
- Bruschetta Stuffed Avocado
- Whole 30 Italian Meatballs
- Caprese Chicken
- Healthy Tuscan Chicken
Did you make Healthy Italian Sausage and Peppers? I’d love to know how it turned out! Leave a comment and a rating below.
While you’re at it, let’s be friends – follow me on Pinterest and Instagram for the latest and greatest.
Recipe
Sausage and Peppers (Keto, Whole30)
Print Recipe Rate this Recipe Pin RecipeRecommended Equipment
- Food Processor
- 4-quart sauce pan
Ingredients
Sausage and Peppers
- 1 lb sweet italian sausage, pork or turkey
- 1 tbsp olive oil
- 1 medium red bell pepper, sliced into ½″ strips
- 1 medium green bell pepper, sliced into ½″ strips
- 1 medium yellow onion, sliced into ½″ strips
- 2 cloves garlic, chopped
- 1 tbsp balsamic vinegar
- 1 28-oz can diced fired roasted tomatoes
- 1 tsp dried basil
- 1 tsp dried parsley
- ½ – 1 tsp red pepper flakes, optional
- ½ tsp dried oregano
- 1 tsp sea or kosher salt
- 3 tbsp fresh chopped basil
Cauliflower Puree
- 1 head cauliflower, cut into florets
- 1 c chicken broth
- ½ tsp sea or kosher salt, plus more to taste
- ¼ – ½ c shredded parmesan cheeese
Instructions
Sausage and Peppers
- Heat dutch oven over medium high heat. Add the olive oil and heat until it shimmers. Add the sausages and sautee 1-2 minutes per side, until browned. The sausage does not need to be fully cooked through at this stage. Remove sausages using tongs and set aside onto a plate. Once cool enough to handle, slice into 1″ coins.
- Add peppers and onions to the dutch oven, toss in the rendered sausage fat, and sautee, stirring frequently, until the edges are charred, about 5 minutes. Add the garlic and sautee until fragrant, about 1 minute. Add the balsamic vinegar to deglaze the pot, scraping up any brown bits from the bottom. Cook until the liquid stops simmering, 1-2 minutes.
- Add tomatoes and their juices, spices, and sliced sausage coins back to the pot. Stir to combine. Cover, reduce heat to medium, and simmer until the sausages are cooked through, about 10 minutes. Stir once or twice to prevent scorching.
- Stir the fresh basil into the sausage and peppers. Taste for seasoning and adjust with salt, pepper, or red pepper flakes to taste.
- Portion the cauliflower puree into bowls, and top with the sausage and peppers. Garnish with additional fresh basil and serve immediately.
Cauliflower Puree
- Combine the cauliflower florets and chicken broth in a 4-quart sauce pot. Place over a high flame and heat until the liquid comes to a boil. Cover, reduce to medium/medium-low to maintain a simmer, and steam until the cauliflower is very soft, approximately 20 minutes.
- Remove the cauliflower using a slotted spoon and place into a food processor. Add the parmesan cheese, starting with ¼ cup, and puree until smooth. Add the residual cooking liquid, a tablespoon at a time, until the consistency is to your liking. Taste for seasoning, and add additional cheese if desired, or salt if needed.
Notes
- Nutritional Information reflects 1 serving of sausage and peppers.
- Cauliflower puree adds the following: 84 cal; 2g fat; 8g carbs; 3g fiber; 6g protein
- Store leftover sausage and peppers separately from cauliflower puree in sealed containers in the fridge for up to 4 days; reheat in the microwave in 30 second intervals, stirring in between.
- Freeze cooked sausage and peppers in a freezer-safe bag or airtight container for up to 3 months; defrost in the fridge overnight, then transfer to a pot and rewarm over medium high heat.
Lindsey
I’ve never read your blog before but somehow I found this recipe (maybe pinterest???). Anyways, this is the best thing ever. My kids hated it but my husband and I were in love. The mixture of the fire roasted tomatoes with vinegar and sausage is perfect.
Rebecca
This was easy and delicious!
Christine
Made this tonight. It was delicious!
Madaline Hernandez
Okay, wow. So I cook for 7 people, 4 adults & 3 kids. My husband & I will eat anything, but everyone else either has an allergy or is just picky. Dinners are very challenging to say the least. My switch to keto has further complicated things & finding a meal everyone will enjoy is so hard. My kids complain more than anyone & I can live with that, but any meal they are even slightly okay with becomes a keeper. (& Cauliflower, ha! Forget it. They hateeeee it)
Well, everyone LOVED this. My kids ate seconds, I was so shocked. They didn’t even realize they were eating cauliflower & I have no plans to tell them otherwise any time soon. I had to make 2 different batches, 1 spicy & 1 not, but everything was so quick & easy I didn’t have a problem doing that. Normally, I’d just omit the spice & add flakes or cayenne to my dish.
THANK YOU, THANK YOU, THANK YOU for this recipe. It is definitely a new staple in my house.
Madaline Hernandez
Update: I had a ton of tomatoes & green peppers left, so today I threw them in the blender with some chicken bone broth, heavy cream, & a handful of fresh basil leaves & it made a killer tomato basil soup. This is seriously the meal that keeps on giving.
Justin
I somehow stumbled on this recipe and it was fantastic (the balsamic vinegar clinched it)! I had frozen riced cauli on hand and quickly microwaved that and threw in the blender with the other ingredients for the puree. This will definitely be a repeat recipe!
Kathy
Googled “Italian sausage, peppers, onions” and this came up. (I’m doing low carb but difficult to come up with delish recipes for the whole family.) Everyone loved this. The fire-roasted tomatoes really brought out a nice flavor along with a touch of balsamic for depth of flavor without any overwhelming vinegar taste. Bookmarked this page and followed on IG as I can tell this woman’s got some excellent culinary skills. Looking through the recipes on this page, I’ll be trying many in the future
Garrett
Absolutely delicious! Made it according to the recipe, and whole family devoured it. Thank you for sharing!