Keto Fettuccine Alfredo Cabbage Casserole with Sausage
This keto fettuccine alfredo cabbage casserole with Italian sausage will make you say, “zoodle, who?”
Move over zoodles, cabbage is in the house!
Using cabbage as a keto pasta substitute is my new favorite, and making this keto fettuccine alfredo with cabbage is nothing short of a miracle. I could eat this every night for a week and still want more! The nice thing about cabbage is that it holds up a lot better than zucchini noodles or “zoodles” and doesn’t get mushy.
How did we hear about this sausage alfredo cabbage?
Inspired by a now-deleted viral TikTok video, I had to try it out myself and share it! The rich keto alfredo sauce is made from butter, cream cheese, sour cream, and heavy whipping cream. It’s seasoned simply with garlic, lemon, salt, and pepper to let the flavors of the sausage shine through. So drool-worthy!
Making this keto fettuccine alfredo casserole is fairly simple.
One of the best things about this meal is that you basically make the whole thing in a baking dish. You put the sliced cabbage, onion, and garlic in the baking dish, then top it with the ingredients that make the alfredo sauce. Then you sprinkle it with the seasonings and throw it in the oven.
While the cabbage is roasting with the alfredo sauce ingredients, you’ll get to cooking the sausage. The final step is adding some parmesan cheese to melt over the cabbage alfredo mixture and finishing by topping it with parsley. Trust me, it’s amazing!
Keto Fettuccine Alfredo w/ Sausage & Cabbage
yield: 8 SERVINGS
prep time: 10 MINUTES
cook time: 45 MINUTES
total time: 55 MINUTES
Sliced cabbage "noodles" roasted with onions, garlic, and a keto alfredo sauce made with cream cheese, sour cream, butter, and heavy whipping cream, then topped with sausage.
Ingredients
- 1 medium head of cabbage
- 1 medium yellow onion
- 4 garlic cloves, minced
- 1/4 cup salted butter (half a stick) + 2 tablespoons, divided
- 2 - 8 oz. blocks full-fat cream cheese
- 1/2 cup full-fat sour cream
- 1/4 cup heavy whipping cream
- 1/2 teaspoon salt
- 1/2 teaspoon pepper
- 1 teaspoon garlic powder
- Lemon juice from 1 large lemon
- 1 cup parmesan cheese, shaved or shredded
- 1 pound Italian sausage links
- 2 tablespoons parsley, chopped, to garnish
Directions
1
Preheat oven to 400 degrees.
2
Slice cabbage into thin strips. Discard large stem pieces. Place in a 9x13-inch baking dish.
3
Slice onion into thin strips and add to the baking dish. Mince garlic and add to the baking dish with the cabbage and onion. Lightly toss to combine.
4
Cut butter into pats and spread evenly over the cabbage. Cut cream cheese into cubes and spread over cabbage.
5
Dollop sour cream evenly over the cabbage. Pour the heavy whipping cream over the cabbage mixture.
6
Sprinkle the salt, pepper, and garlic powder over the cabbage mixture.
7
Bake cabbage for 35 to 40 minutes, until just starting to brown.
8
While the cabbage is baking, cook the sausage links. Melt 2 tablespoons butter in a skillet over medium heat. Place sausages in skillet and brown all sides until fully cooked, about 15 to 20 minutes. Remove from heat and let rest for a few minutes, then slice each sausage link into 6 pieces.
9
Once the cabbage is done baking, remove it from the oven and mix in the lemon juice and parmesan cheese. Top with the sausage pieces and gently mix them in with the cabbage. Place the baking dish back in the oven and bake for another 10 minutes to melt the cheese.
10
While the cheese is melting, chop the fresh parsley. When done, remove the dish from the oven and garnish it with parsley. Enjoy!
Nutrition Information
Yield: 8 servings, Serving Size: 1 serving
Amount Per Serving:
538 Calories | 43.6g Fat | 16.8g Total Carbs | 3g Fiber | 8.5g Sugar | 20.9g Protein | 13.8g Net Carbs
Tips for making the best keto alfredo cabbage with sausage:
- Slice the cabbage as thin as you can, about a 1/4-inch thick to make your “fettuccine”. Roasted cabbage makes wonderful keto “noodles”. Be sure to discard the large, tough stem pieces.
- Don’t skip out on the lemon in this recipe. It adds a wonderful brightness to the dish. You could use 3 tablespoons of bottled lemon juice if you don’t have a fresh lemon.
- I used Italian sausage but you can use any sausage links; brats or even kielbasa will work!
So tasty and filling!
This keto sausage alfredo with cabbage is so satisfying. I wasn’t joking when I said I could eat it every night! The keto alfredo sauce takes the prize with this dish, and of course, the cabbage noodles are incredible. They’re so good, I might not ever use zoodles again.
My Hip sidekick Lina made this recipe and here’s what she had to say:
“Wow, this keto sausage cabbage alfredo was so AMAZING!! You won’t miss the traditional noodles with yummy tender roasted cabbage. It’s so much cheese which is super fantastic and filling! The sausage just throws it over the edge delish. You can even try smoked sausage which would be yummy. Honestly, this is one of the best keto meals I’ve had and it’s a must-try. Plus having it made in a casserole dish is super easy and convenient!”
Looking for more keto inspiration, check out our recipe for keto sausage stuffing!
Any other option other than cabbag?
I cannot stomach the smell or texture of it.
Hey there! You could do any vegetable or keto noodle substitute. We suggest zoodles or the Palmini linguine. Hoping this is helpful!
I fixed this tonight and didn’t notice the “typical” cabbage smell nor the texture. It was wonderful!
the cabbage Fettucine is fantastic wit a pound of small cooked shrimp
That does sound delicious! Thanks for the suggestion!
How many cups is the measurement on 1 medium cabbage? My store sells the cabbage already chopped up.
Hi Tandy! I did search for this and found that One Medium Cabbage shredded is about 8-8.5 cups. Hoping that is helpful!
Can this be used for meal prep? Just wondering how well it would reheat and for how many days. Making it tonight and can’t wait!
Yes! You can reheat it for up to 3 days, Ashley!
I just made a mash up of this. Corned beef ( instead of sausage), Swiss (instead of Parmesan), left out the lemon. It’s so delicious!
Sounds yummy, Beth!
I only used 3 oz of cream cheese and 2 tablespoons of sour cream. After the sausages cooked I made Alfredo with butter, heavy cream, and parmasean. Added the Alfredo when adding the cut sausages. I also added some cut up broccoli to the cabbage before baking. Delicious!
Sounds yummy, Angela! Thanks for letting us know how yours turned out for you! ❤️🤗
Do you know the net carbs after changing the amount of cream cheese?
Hey Kristie! You could enter the ingredient amounts you decide to use, into one of these apps to grab the nutritional values. 💖 https://hip2keto.com/tips/best-keto-apps/
Can I freeze the leftovers
Hey Debbie! We haven’t tried that, but it may work if stored in an air tight container.💞 Let us know how it works out for you if you do!🤗💖
I made this tonight and am freezing a portion. I put in a glass pie plate used the cling wrap first then aluminum foil. Will probably put it in a plastic freeze bag. By the way, it was delicious and I did the recipe as written, except used Jane’s crazy mixed up salt.
Yay! Thanks for sharing how yummy it turned out for you, Mary! 😋 Super happy you enjoyed it! 🙌💖
Is the cabbage typically still crunchy? Cooked/baked as directed, but it was almost like eating hot cole slaw. Flavor is excellent, though, so I would consider another attempt.
Hi Brandy! You will want to slice the cabbage as thin as you can and be sure to discard the large, tough stem pieces. You may need to cook longer until the cabbage starts to brown. Let us know how the second attempt turns out.
Not a fan.
I ate a small amount, but not my thing I guess.
Thanks for letting us know what you thought of this recipe, Karen.
I just made this and can’t wait to try it – it looks and smells delicious!! What is the serving size? It says 8 servings but not what the amount is.
Hey Shanna! The serving size is 1 1/2 cups! Hope you love it! 🙌🥰
This was amazing!! I was anxious with the amount of cream cheese while layering but it turned out perfect!
WOOHOO! SO happy to hear this recipe turned out well and you loved it, Cassandra! 💖
My sauce isn’t “saucy” – I think it broke. Is it supposed to be smooth like an Alfredo sauce?
Any suggestions to remedy it? The flavor is fantastic.
Hey Kato! Glad to hear you enjoyed the flavor in this recipe! You might try adding more heavy cream or broth to your sauce, if you prefer it to be a little more fluid! Hoping this helps! ❤️
Any one know about how many calories are in a serving?? Doing a calorie deficit and loved this meal with the cabbage. Will be a make again in our house! 😀
YAY! So happy you enjoyed this meal, Betty! 🤗 This recipe yields 8 servings. The suggested 1 serving size is 538 Calories. 💞
Hey! Hoping to try this this weekend. Is it possible to use uncooked sausage and remove the casing/break it up into small chunks and bake it with the cabbage for the 35-40min? Or is it important for some reason to cook them separately? Thanks!! 🙂
Hi Kelly! You could try cooking together, however you’ll want to make sure that the sausage is fully cooked once the cabbage is browned. Let us know how it turns out if you decide to try it this way! ❤️
I made enough for two servings of cabbage Alfredo to go beside my steak.the parmasean and garlic flavors came through and was wonderfully filling!
I streamed the Cabbage.. I lived the crunch.
So happy to hear this was filling and you enjoyed the flavors! 😊💕
Is a serving about a cup? When finished? Made this and it was so good.
Hey there, Liz! The serving size is about 1 1/2 cups. Happy to hear you enjoyed it! 🥰
This recipe inspired my Lazy Girl way:
1 bag shredded cabbage
1 onion sliced
1 jar Rao’s Alfredo
1 bag frozen turkey meatballs
All in a pan with salt & pepper, 400 degrees, 40 minutes. Top with Parmesan and 10 minutes more.
Delicious!
Thanks for sharing how you made this, Courtney! Happy to hear it was delicious! 😋❤️