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    You are here: Home » Meal Type » Main Dishes

    Healthy Italian Sausage and Peppers

    5 from 14 votes
    January 21, 2021 (updated October 14, 2024) by Danielle Esposti

    May contain affiliate links. See our Privacy Policy and disclosure.

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    Pinterest image for a healthy sausage and peppers recipe.
    Pinterest image for a whole30 and keto sausage and peppers recipe.
    Pinterest collage for a whole30 and keto sausage and peppers recipe.
    Pinterest collage for a healthy sausage and peppers recipe.

    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.

    Two bowls of low carb italian sausage and peppers over gluten free cauliflower puree on a cement background with a grey linen napkin.
    Jump to:
    • Healthy Sausage and Peppers
    • Tips for Making Sausage and Peppers Perfectly
    • How to Serve Sausage and Peppers
    • More Healthy Italian Recipes
    • Sausage and Peppers (Keto, Whole30)
    • Ratings

    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. 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.

    A collage showing how to make healthy sausage and peppers.

    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 
    Side view, sausage and peppers over cauliflower puree in a bowl with a fork and dark grey linen napkin.

    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.

    A bowl of healthy italian sausage and peppers over gluten free cauliflower puree on a cement background with a grey linen napkin.

    Sausage and Peppers (Keto, Whole30)

    5 from 14 votes
    author: Danielle Esposti
    yield: 4
    calories per serving: 371
    prep time: 15 minutes mins
    cook time: 30 minutes mins
    total time: 45 minutes mins
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    Description

    Get out your red checkered tablecloth and that chianti bottle with the candle in it. Old-school Italian gets a makeover for the new year in this healthy Sausage and Peppers recipe. Get your links nice and brown in a dutch oven and remove. Saute peppers, onion and garlic, then deglaze. Add in tomatoes, sliced sausage, and simmer. Serve over cauliflower puree and garnish to taste.
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    Ingredients
     

    Sausage and Peppers

    • 1 lb sweet italian sausage, pork or turkey
    • 1 tablespoon 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 tablespoon balsamic vinegar
    • 1 28-oz can diced fired roasted tomatoes
    • 1 teaspoon dried basil
    • 1 teaspoon dried parsley
    • ½ – 1 teaspoon red pepper flakes, optional
    • ½ teaspoon dried oregano
    • 1 teaspoon sea or kosher salt
    • 3 tablespoon fresh chopped basil

    Cauliflower Puree

    • 1 head cauliflower, cut into florets
    • 1 c chicken broth
    • ½ teaspoon 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.
      Italian sausage links browning in a dutch oven.
    • 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.
      Sauteed onions and bell peppers in a dutch oven.
    • 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. 
      Top - sliced italian sausage on a cutting board; bottom - sausage and peppers before simmering.
    • Stir the fresh basil into the sausage and peppers. Taste for seasoning and adjust with salt, pepper, or red pepper flakes to taste.
      Keto and whole30 sausage and peppers in a dutch oven.
    • Portion the cauliflower puree into bowls, and top with the sausage and peppers. Garnish with additional fresh basil and serve immediately. 
      Sausage and peppers over cauliflower puree in a bowl with a dark grey linen napkin.

    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. 
      Steamed cauliflower florets in a pot.
    • 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.
      Steamed cauliflower florets with parmesan cheese and cashew milk in a food processor before and after pureeing.

    Recipe 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
    Storage and Reheating
    • 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. 

    Nutrition Facts

    serving size:
    calories per serving: 371 kcal
    total fat: 24g
    saturated fat: 8g
    monounsaturated fat: 3g
    polyunsaturated fat: 1g
    trans fat: 0g
    cholesterol: 68mg
    sodium: 1085mg
    protein: 21g
    total carbohydrates: 16g
    fiber: 3g
    sugars: 5g
    potassium: 299mg
    vitamin a: 147%
    vitamin c: 90%
    calcium: 14%
    iron: 11%
    DID YOU MAKE THIS RECIPE?Tag @oursaltykitchen on Instagram and hashtag it #oursaltykitchen!
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    Disclaimer: This post and the recipe card may contain affiliate links, which means we receive a small commission (at no cost to you!) if you make a purchase using these links. Rest assured, we only endorse products we own and truly love!

    10 Comments
    Filed Under: Gluten Free, Grain Free, Kid Friendly, Main Dishes, Whole30 Recipes

    Reader Interactions

    Comments

      5 from 14 votes (6 ratings without comment)

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      Recipe Rating




    1. Lindsey

      August 28, 2019 at 7:35 pm

      5 stars
      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.

      Reply
    2. Rebecca

      December 02, 2019 at 2:43 pm

      5 stars
      This was easy and delicious!

      Reply
      • Christine

        February 12, 2020 at 6:06 pm

        5 stars
        Made this tonight. It was delicious!

        Reply
    3. Madaline Hernandez

      May 20, 2020 at 7:51 pm

      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.

      Reply
      • Madaline Hernandez

        May 23, 2020 at 5:50 pm

        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.

        Reply
    4. Justin

      January 29, 2021 at 11:28 am

      5 stars
      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!

      Reply
    5. Kathy

      January 23, 2022 at 9:44 am

      5 stars
      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

      Reply
    6. Garrett

      May 01, 2023 at 9:32 pm

      5 stars
      Absolutely delicious! Made it according to the recipe, and whole family devoured it. Thank you for sharing!

      Reply
    7. Hannah C

      April 01, 2024 at 4:15 pm

      5 stars
      This recipe is so insanely good. Super full of flavor, and the addition of balsamic is such a nice touch.

      Reply
    8. Keri

      February 13, 2025 at 7:42 am

      5 stars
      This was absolutely delicious and so easy to make. Definitely added to my personal recipe book!

      Reply

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    Welcome to OSK, we're so glad you're here! We share simple, seasonal recipes with bold, restaurant-quality flavors that any home cook can master (yes, even you!). You'll find cooking tutorials for beginners, inspired ideas for seasoned home cooks, and a sprinkle of sass for everyone.

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