Creamy Baked Spaghetti Squash with Sausage and Tomato Cream Sauce

4.60 from 5 votes
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This Creamy Baked Spaghetti Squash Casserole recipe is healthy comfort food packed not only with veggies, but also with amazing flavors. You’ll love the rich but not too heavy tomato cream sauce, and turkey sausage makes it hearty and satisfying. This low carb and gluten free casserole is an easy dinner that’s perfect for any night of the week.

Spoon starting to dig in to the Spaghetti Squash Casserole in a white baking dish

Originally published on March 10, 2012. Photos updated on March 28, 2016.

What is spaghetti squash?

Spaghetti squash is a great pasta alternative for people like me who have to avoid gluten, or those that have to watch their carb intake. It is a winter vegetable that is low calorie and high in fiber, vitamin C, and antioxidants.

Plus it is naturally gluten free and, when cooked, the flesh can be shredded into “noodles” so you can enjoy it much like traditional pasta.

And let’s not forget that it’s delicious. I’d actually take spaghetti squash instead of noodles any day.

Sometimes I am happy to just eat it with basic tomato sauce, Vegan Vegetable Tomato Sauce with Chickpeas, or even Classic Vodka Sauce. And the other day, when I was craving fall flavors, I poured over Pumpkin Cauliflower Alfredo.

But other times I want a change from just topping it with a sauce. This baked spaghetti squash recipe has been a favorite of several friends over the years, plus my family as well.

Maybe you haven’t tried spaghetti squash yet. This is a great dish to make to start out because it is super easy and absolutely delicious. It is a healthy, low carb, gluten free dinner even the biggest pasta-lovers will enjoy!

But if you aren’t quite ready to make the spaghetti squash leap, at least try the sauce over some spaghetti or penne or whatever pasta shape you prefer.

Spaghetti Squash with Sausage and tomato cream sauce served on a plate

How to Make Spaghetti Squash Casserole

Spaghetti squash noodles are covered in a simple sauce with a little kick from the spicy sausage. But it is smoothed out by the bit of cream that makes the sauce rich and velvety. A few peas add a pop of texture and color, and of course we all know that no pasta (or fake pasta) casserole is complete without some cheese on top.


Here is a brief overview so you can see just how easy it is to make. Scroll down to the printable recipe card for the full quantities and details.
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Recipe Ingredients

This baked spaghetti squash casserole recipe is pretty straightforward! Here’s what you’ll need to make it. Scroll down to the recipe card for amounts.

  • Spaghetti squash
  • Sausage links – I like to use the raw (not pre-cooked) hot turkey sausages to keep it a bit leaner and add a little spice. But you can use pork sausage and choose if you prefer spicy or mild.
  • Onion
  • Red wine – don’t cook with alcohol? You can omit this or add a splash of balsamic vinegar.
  • Canned crushed tomatoes – I typically use the Tuttorosso brand when I am using crushed tomatoes. It has a little basil in it, so if you use a brand without basil, you may want to add a little fresh or dried basil.
  • Dried oregano
  • Salt & pepper
  • Heavy cream
  • Grated parmesan cheese – for the sauce and for sprinkling on top.
  • Fresh or dried parsley
  • Frozen peas – these are optional, but I like the pop of color and texture.
  • Shredded mozzarella cheese – you can also use fresh mozzarella if you prefer.


  • Skillet
  • Baking dish – you’ll need a 1 1/2-2 quart glass or ceramic baking dish or casserole dish. I like to use the 1 1/2 quart oval French White Corningware from this 12-piece set. These are my go-to baking dishes.
Spaghetti Squash Casserole served on a plate

What to do

  1. Chose your favorite method for how to cook spaghetti squash – oven, microwave Instant Pot, slow cooker, or even the grill. Scrape out the “noodles” with a fork.
  2. Brown the sausage in a pan, then add onion and cook till soft and translucent.
  3. Stir in the wine, a can of crushed tomatoes, and the seasonings.
  4. Let it simmer a bit before stirring in heavy cream, parmesan cheese, and frozen peas.
  5. You’ll then pour the sauce over your spaghetti squash. If there’s too much, just save the extra to pour over later or to use for something else.
  6. Transfer the saucy squash noodles to a baking dish, top with mozzarella cheese and parmesan cheese, then bake until hot, melty, and golden.
White corningware baking dish filled with spaghetti squash casserole

Make it a Meal

You really don’t need anything else, but you can serve it with some simple sides.

Plate of baked spaghetti squash with tomato cream sauce

More spaghetti squash recipes

Baked Spaghetti Squash with Sausage

This spaghetti squash casserole is a healthy, gluten free, low carb comfort food that’s just as creamy, cheesy, and delicious as any pasta casserole recipe. You’ll love the rich tomato cream sauce. And it’s hearty and satisfying with just a bit of heat from a few links of spicy sausage to add the perfect amount of kick.

A baking dish fill of Baked Spaghetti Squash casserole.
4.6 from 5 votes

Baked Spaghetti Squash Casserole with Spicy Sausage Tomato Cream Sauce

A healthy, gluten free, low carb comfort food that’s just as creamy, cheesy, and delicious as any pasta casserole recipe.
Prep: 15 minutes
Cook: 20 minutes
Total: 35 minutes


  • 1 spaghetti squash
  • 3 raw turkey sausage links hot or mild, or you can use pork sausage
  • 1/2 large sweet onion, chopped
  • 1/4 cup red wine
  • 15 oz crushed tomatoes (I typically use Tuttorosso when I am using crushed tomatoes. It has a little basil in it, so if you use a brand without basil, you may want to add a little fresh or dried)
  • 1/2 teaspoon dried oregano
  • 1/2 teaspoon kosher salt
  • freshly ground pepper
  • 1/4 cup heavy cream
  • 1/4 cup grated parmesan cheese
  • 1 Tablespoon fresh parsley or 1 teaspoon dried parsley
  • 1/2 cup frozen peas optional
  • 1/4 cup shredded mozzarella cheese
  • 3 Tablespoons grated parmesan cheese for topping


  • Cook the spaghetti squash in your desired manner (see link in Notes for five methods) and scrape out the "noodles". Preheat or keep your oven set at 400ºF.
  • Heat a pan over medium heat.
  • Squeeze the sausage out of the casings into the pan, and cook until is cooked through and browned.
  • Add the onions and saute until translucent and soft.
  • Add the wine, tomatoes, oregano, salt, and pepper, and simmer until it is hot and the onions are fully cooked.
  • Stir in the heavy cream, parsley, ¼ cup parmesan cheese, and frozen peas.
  • Pour enough sauce over the squash noodles until it is as saucy as you like (there may be some extra sauce, which you can serve on the side).
  • Pour the mixture into a 1 1/2-2 quart glass or ceramic baking pan or casserole dish that has been sprayed with olive oil or cooking spray.
  • Sprinkle the mozzarella cheese evenly across the top of the casserole.
  • Bake for about 10-15 minutes, or until hot and bubbly, and the cheese is golden brown.


See how to make spaghetti squash in your oven, microwave, slow cooker, Instant Pot, or grill.
Nutrition Facts
Baked Spaghetti Squash Casserole with Spicy Sausage Tomato Cream Sauce
Amount Per Serving (1 g)
Calories 298 Calories from Fat 135
% Daily Value*
Fat 15g23%
Saturated Fat 7g35%
Cholesterol 45mg15%
Sodium 772mg32%
Potassium 683mg20%
Carbohydrates 28g9%
Fiber 6g24%
Sugar 12g13%
Protein 12g24%
Vitamin A 1095IU22%
Vitamin C 23.4mg28%
Calcium 256mg26%
Iron 2.8mg16%
* Percent Daily Values are based on a 2000 calorie diet.



  1. Angel

    Wow. Just yum. I have made a lot of spaghetti squash recipes. Some are good. Some are really not. This is by far my favorite spaghetti squash dish ever. This is probably up there with one of my favorite dishes ever, period. Soooooo goooood

  2. Nan

    5 stars
    I made the Baked Spaghetti Squash Recipe with Spicy Sausage Tomato Cream Sauce. Your recipe is perfect, except I poured in most of the sauce. It was our first spaghetti squash recipe and we loved it! Thanks much!

    1. Brianne Cupcakes & Kale Chips

      I’m so sorry for the delay in our response. The mozzarella cheese is placed on top of the casserole before it gets baked in the oven.

  3. This recipe looks enticing and delicious. In September, I will be publishing a recipe round up featuring baked spaghetti, and I was wondering if I can include your baked spaghetti squash recipe in my round up and use one of your pictures. I will link back to your site for the recipe. Thanks for your consideration.

  4. carol napolitano

    Hi my friend, love all your recipes, I just noticed the way you made this sauce, you put onions after cooking the meat, that’s how I make my pasta sauce, I put lots of onions and 2 cloves of garlic. It seems like if you brown the onions slightly to bring out the sugar in the onion, it will sweeten the sauce naturally, and give a nice flavor. I learned that from a woman who was from Italy and my dad who ‘s a baker and can cook like a little ole Italian lady. If you like onions that is, but I think onions or garlic should go in the sauce after the meats are cooked, just like you did here, but I notice you didn’t do that for your lasagna sauce. I’m sure with all those flavors it wasn’t even noticed, but I was just curious. I ‘m gonna try this recipe, it’s almost like a vodka sauce, without the vodka, just the cream, plus I love peas. Sounds yummy, can’t wait to try, my son has been on this low carb. way to eat, so this will work out great. Oh yeah, just wanna say, I use the Barilla, no cook noodles too, their so much thinner and taste like fresh noodles. I even put a small amount of cream cheese in my cheese mixture a few times, I love spinach mixed in too. Thanks. Keep on cooking!

  5. Foodie Friends Friday (Part 1) Featuring Marlys of This and That – June 8, 2012

    […] Squash Quiche.  Now I love spaghetti squash, but have pretty much used it solely as a gluten-free spaghetti substitute.  So I thought the idea of using it in a quiche, particularly a crustless quiche, was a unique and […]

  6. […] and all kinds of other sweet treats, when truthfully, I have gotten more positive responses to my spaghetti squash and oatmeal and granola  and millet recipes than my Lucky Charms Cupcakes (the Chocolate Coconut […]

  7. Friday Fun! March 16, 2012 | Cupcakes & Kale Chips

    […] In the early stages of tonight’s insomnia, I found this article about food bloggers posting recipes using “real food” versus packaged items and junk food to create visually appealing, drool-inducing recipes that don’t do wonders for the health of the nation.  I am all about balance and moderation.  So while I do try to focus on wholesome, nutritious, “real” food, I do think there is room in life for a little fun, like these Lucky Charms Cupcakes.  That being said, though, so far I think the most popular recipe on my blog is my Spaghetti Squash with Spicy Sausage Tomato Cream Sauce. […]

      1. Samantha

        I made it tonight and got rave reviews! It was delish! I used peas and all the sauce. Also, i added more mozzarella cheese.

  8. OMG I do not like spaghetti squash, but I think I could get DOWN with this recipe! I’m so going to give it a try. Thanks so much for stopping by my facebook page!

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