Pizza Casserole is a wonderfully easy dinner recipe

Pizza Casserole Recipe

Pizza Casserole Recipe
Pizza casserole: That doesn’t sound too healthy when you first hear it. But if you’re a pizza fan, you’re going to really love this low-carb meal. It’s made with spaghetti squash, a vegetable that’s packed with fiber and vitamin C.

This recipe is also reminiscent of a supreme pizza, with a healthy amount of lean ground bison, which is full of protein and nutrients. It also has all your favorite pizza fixings: garlic, oregano, basil, pizza sauce and cheese. Yum! So the next time you’re tempted to order a pizza, try this comforting, good-for-you pizza casserole instead.

Pizza casserole step 1 - Dr. Axe

Preheat the oven to 400 degrees F. Over medium-high heat, kick off by sautéing the onions, bison and garlic. Drain off the fat that’s accumulated from the meat and add in the seasonings.

Pizza casserole step 2 - Dr. Axe

Then, transfer the ingredients to a large mixing bowl. Next, stir in the spaghetti squash, sauce, eggs and just half the cheese — I know, it’s hard to resist eating all that cheese! Once you’ve stirred everything up, move the whole mix to a 9- by 13-inch greased pan.

Pizza casserole recipe - Dr. Axe

Then finish off the pizza casserole by topping it with the remaining pecorino cheese and sliding it into the oven. Let it bake for the next 30 minutes before slicing and enjoying!

I love how this pizza casserole has all the flavors and is just as tasty as a pizza pie, but is actually good for you. Try this recipe on your next pizza night. I promise you won’t regret it.


Total Time

45 minutes



Diet Type


  • 1 pound ground bison
  • 1 onion, diced
  • 6 garlic cloves, minced
  • Sea salt to taste
  • 1 teaspoon oregano
  • 1 teaspoon thyme
  • 1 teaspoon basil
  • 4 cups cooked spaghetti squash
  • 2 cups pizza sauce
  • 2 eggs
  • ½ cup pecorino cheese, grated


  1. Preheat oven to 400 degrees F.
  2. In a skillet over medium-high heat, sauté bison, onions and garlic.
  3. Drain off excess fat and add in seasonings.
  4. Transfer ingredients to a bowl and add in spaghetti squash, sauce, eggs and half the cheese.
  5. Transfer mixture to a greased 9x13 pan. Top with remaining cheese and bake for 30 minutes.

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