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Keto Sausage and Peppers

There are so many dishes that I've been making for years that have never made it to Heal Nourish Grow yet and this keto sausage and peppers recipe is one of them. It's on repeat in our house about every two to three weeks. When we were moving and staying with friends for a few days, I bought some sausage on sale. Her first suggestion to use it was sausage and peppers! It reminded me that I should finally get this recipe posted. It's delicious and easy, which is why it's in our rotation so often.

I created this as a standalone recipe since you may not want to make a big batch of keto marinara first. However, if you always have some on hand frozen like I do you can make this keto sausage and peppers even quicker.

This is an Italian inspired dish. Most internet sources say that it was created by Italian American immigrants. It's often served as street and festival food in the United States. It may have originated at the Feast of San Gennaro where it was first served back in 1927, but if you search “salsiccia e peperoni” on Italian Google, there are plenty of recipes. Regardless of the origin of this dish, it's simple and delicious!

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Keto Sausage and Peppers

Keto Sausage and Peppers

This keto version of sausage and peppers doesn't require a lot of variation from the original to make it keto friendly. The carbs in this dish all come from whole foods sources rather than pasta or bread. To make this dish fully keto, we skip the typical addition of sugar in the sauce. Simply use your favorite pasta substitute in place of wheat noodles. My favorites are zoodles or Natural Heaven noodles.

If you have my keto marinara on hand, you can skip some steps. Just cook your peppers in some olive oil until softened then add a two cups of marinara sauce. After that you'll move forward with the recipe by adding your browned sausage.

This dish is slightly higher carb due to the peppers and onions. The best way to make sure your keto sausage and peppers has as few carbs as possible is to use Dry Farm Wines (less than one carb in the whole bottle) and make sure your sausage doesn't contain any sugar. You can also halve the amount of peppers and onions. This reduces the carb count by four and a half per serving.

Keto Sausage and Peppers

Prep Time: 10 minutes
Cook Time: 40 minutes
Total Time: 50 minutes
Servings: 8 servings


  • 2 tablespoons extra virgin olive oil
  • 1 ½ pounds Italian sausage, hot or mild
  • 2 large red bell peppers, sliced
  • 2 large yellow bell peppers
  • 2 large yellow onions, sliced
  • 4 garlic cloves, minced
  • 1 teaspoon salt
  • 1 teaspoon freshly ground black pepper
  • ½ teaspoon dried oregano
  • ½ cup chopped fresh basil leaves
  • 1 cup dry red wine
  • 28 ounces diced tomatoes
  • ¼ teaspoon red pepper flakes, optional
  • ½ cup parmesan cheeese, optional


  • Heat the oil in a large skillet over medium heat.
  • Place the sausages in the oil and cook until brown on both sides, remove from pan.
  • Keeping the pan over medium heat, add the garlic, peppers, onions, salt, and pepper and cook until onions start to soften, about 5 minutes.
  • Add the oregano and basil and cook 2 more minutes.
  • Add the wine, tomatoes and chili flakes, if using. Stir to combine and bring to a simmer.
  • Cut the sausages into 1 inch pieces. Add the sausage back to the pan and stir to combine.
  • Cook until the sauce has thickened, about 20 minutes.
  • Serve in bowls, over zucchini or on a keto sandwich roll topped with some parmesan cheese, if using.



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Serving: 1servingCalories: 408kcalCarbohydrates: 14gProtein: 14gFat: 31gSaturated Fat: 10gPolyunsaturated Fat: 4gMonounsaturated Fat: 15gCholesterol: 65mgSodium: 1060mgPotassium: 652mgFiber: 3gSugar: 6gCalcium: 67mgIron: 3mgNet Carbohydrates: 11g

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