If you’ve been on the hunt for a delicious low-carb casserole that fits the bill in flavor and nutrition, then you’ve landed in the right place. This Creamy Sausage Casserole with Tomatoes is packed with veggies and filled with protein to leave you feeling satisfied and satiated. Make it your own by pairing this sausage recipe with a salad, veggie pasta, or classic spaghetti and toasted bread… your choice!

Jump to:
- Why you need to make this Casserole with Sausage Recipe
- What You Need to Make this Recipe for Sausage Casserole with Cream Cheese
- How to Make this Sausage Baked with Cream Cheese
- Recipe Notes + Expert Tips
- FAQs for this Creamy Casserole with Sausage
- Other Casserole Style Recipes You May Enjoy
- Creamy Sausage Casserole with Tomatoes
Why you need to make this Casserole with Sausage Recipe
Have you seen the viral TikTok feta pasta trend? If you haven’t, definitely take a moment and do a quick Google search of it. It’s amazing to see how such simple ingredients tossed together for a one pan meal went viral overnight!
Nonetheless, it definitely caught my attention! After trying a few different versions and sharing then with my Instagram following, I knew this baked cream cheese meal with sausage was the winner, and I had to share here with you too!
I will admit, I’m not a HUGE pasta fan (although if you’re looking for a shoo-in, creamy pasta recipe, my Healthy Turkey Tetrazzini definitely fits that bill). I much prefer the veggies, creamy sauce, and protein to the noodle. And… I LOVE bread and would much rather get my carbs in by dipping my crusty slice into a casserole!
Not to worry! Whatever your preference is (low carb or higher carb) you can make this your own by adding a pile of pasta into your bowl before serving up this Creamy Sausage Casserole with Tomatoes!
What You Need to Make this Recipe for Sausage Casserole with Cream Cheese

Ingredient Tips
- Tomatoes: Use grape or cherry tomatoes here! Large tomatoes chopped into pieces won’t have quite the same effect.
- Sausage: You can use any precooked sausage links, i.e., pork, beef, turkey, or vegetarian/vegan, in this recipe. Sausage with sweet Italian flavors, or hot Italian sausage if you like heat, would be delicious!
- Herbs and spices: In addition to using Italian sausages, you could really turn this recipe into an Italian sausage casserole by sprinkling some dried oregano and parsley over all the ingredients before tossing together!
Ingredient Swaps
- Spinach: Baby spinach can be replaced with baby kale (or regular kale, chopped with stems removed). You can also use frozen spinach in a pinch; make sure the spinach is defrosted and squeezed to remove as much water as possible.
- Cream cheese: If needing a dairy free alternative, dairy free cream cheese can be used (note the cheese may cook a tad differently depending on what it’s made from.)
- Veggies: Feel free to volumize with more veggies (and a great way to use up any that may be taking up space in you refrigerator drawers!). Chopped peppers, zucchini, broccoli, or green beans work wonderfully in here, too!
How to Make this Sausage Baked with Cream Cheese
Begin by preheating the oven to 425 degrees F.
Step 1:
Firstly, drizzle 1 Tbsp of the olive oil over the bottom of a large casserole dish. Then toss the onions, garlic, tomatoes, and sausages together. Sprinkle the Italian seasoning on top.

Step 2:
Create a well in the center, add the cream cheese, the drizzle remaining olive oil on top.
Step 3:
Bake the casserole for 35 to 40 minutes, or until top is lightly browned.

Step 4:
When ready, remove from oven. Carefully mix in the spinach until fully combined with the tomatoes and sausage.

Step 5:
Lastly, let sit 5 minutes for the spinach to wilt, then serve your Creamy Sausage Casserole with Tomatoes warm!

Recipe Notes + Expert Tips
- Any leftovers can be transferred to an airtight container and stored in the refrigerator for up to 5 days. I do not recommend freezing this dish!
- As mentioned, this recipe was inspired by the baked feta trend. If you’d rather give that a try, sub in your favorite light feta and follow the same procedure! Note, this won’t be as creamy but the does soften up and can be broken apart and mixed with the veggies!
- To increase the carbohydrates in this recipe, feel free to:
- Serve with crusty bread:

- Or pair with a whole grain or chickpea (for gluten free friends) pasta!

FAQs for this Creamy Casserole with Sausage
Yes! Follow the procedure as directed, then allow to cool slightly before stashing in the refrigerator. When getting ready to serve, bake for 20-30 minutes in a preheated 425 degrees Fahrenheit oven until the whole casserole is cooked through!
Note that cooling and reheating after this prep ahead/cook later method is not recommended. For food safety reasons, it leaves more opportunities for pathogens during cooling/reheating and also, the taste and texture may become altered with repeated cooling and reheating.
My philosophy is that there is a place for any and all foods you enjoy as party of a healthy diet! I answered this more fully in my post a few years ago, so check out Diet Tips to Improve Heart Health- Try This Versus That. To summarize, we do want to be mindful of saturated fats and sodium in our diets.
However, if foods that are higher in these constituents are eaten every-once-in-a-while and are chosen smartly, there is no reason to totally remove them from your diet! For example, when choosing a store bought sausage for this casserole recipe, try to look for something like Bilinski’s Organic Chicken Sausage. I am not sponsored by them but if you take a look at the ingredients, it’s a very short list with no mystery ingredients, and has much less sodium than other options. Eat well and in moderation!
Other Casserole Style Recipes You May Enjoy
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Creamy Sausage Casserole with Tomatoes
Ingredients
- 3 tbsp olive oil divided
- 2 tsps minced garlic
- 1/3 cup chopped onion
- 1 1/2 cups grape tomatoes
- 4 each chicken sausages thinly sliced
- 1 tsp Italian seasoning
- 8 ounce light cream cheese
- 4 cups spinach
- salt/pepper to taste
Instructions
- Preheat oven to 425 degrees F.
- To a large casserole or baking dish (about 9 x13-inch), drizzle 1 tbsp of the olive oil on the bottom. Add the onion, garlic, tomatoes, and chicken sausage, then sprinkle the Italian seasoning on top and mix it all together. Create a well in the center and place the cream cheese in it.
- Drizzle remaining olive oil on top and place in the oven for 35 to 40 minutes. When top of the cream cheese is lightly browned and tomatoes have blistered, remove from oven and add the spinach. Mix the spinach and cream cheese into the other ingredients until uniformly combined. Let sit 5 minutes to allow spinach to wilt.
- Serve warm over pasta, with sliced bread, or a side salad for a lower carb option. Add salt/pepper to taste.
Notes
- Any leftovers can be transferred to an airtight container and stored in the refrigerator for up to 5 days. I do not recommend freezing this dish!
- As mentioned, this recipe was inspired by the baked feta trend. If you’d rather give that a try, sub in your favorite light feta for the cream cheese, and follow the same procedure! Note, this won’t create the creamy sauce that the cream cheese does, but once the feta is baked, it does soften up and can be broken apart and mixed with the veggies!
- To increase the carbohydrates in this recipe, feel free to serve with crusty bread or pair with a whole grain or chickpea (for gluten free friends) pasta!
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