Our spaghetti squash with sausage recipe is a reader favorite. Make a double batch because it’s that good! 

Spaghetti Squash Recipe with Sausage | Healthy Spaghetti Squash Recipe in a cast iron skillet

Easy Spaghetti Squash Recipe

We are obsessed with healthy spaghetti squash recipes. Whether it’s spaghetti squash baked in the oven or cooked in the microwave for a quick and easy dinner. This spaghetti squash recipe with Italian sausage and parmesan cheese is another favorite that doesn’t ever get old. Sure, there’s more calories in this version, but when you’re wanting to splurge, this is the spaghetti squash dinner to make!

Video: Spaghetti Squash Recipe with Sausage

Spaghetti Squash Recipe with Sausage | Healthy Spaghetti Squash Recipe in a cast iron skillet with fork

Tons of Flavor and Texture

Sauteed with some onion, garlic and chunks of delicious italian sausage, it’s a great base to eat with spaghetti squash. But wait, this recipe gets better.

  • Cheeses: There’s different cheeses that you can add. Crumbled feta cheese, shredded cheddar, smoked gouda and some blue cheese are some different ideas. We add some awesome aged parmesan cheese and voila! the flavor and textures become even more tremulous. The savory flavors of the parmesan really make this spaghetti squash dish outstanding.
  • Sauces:  Just add some pasta sauce on the spaghetti squash and it’s the perfect Italian spaghetti squash version that you’ll love forever and ever. If you like white sauces like Alfredo sauce, this is a great addition too.
  • Add some vegetables: Steamed broccoli, roasted veggies like cauliflower, broccoli or squash are great additions. Sautee some spinach or kale for extra nutrients from these popular greens.

Low Carb Paleo Spaghetti Squash Recipe

If you’ve never had spaghetti squash before, you love it! It’s a great low carb and healthier way to enjoy pasta without all the calories. When cooked, the spaghetti squash flesh breaks apart into thin strands, just like thin spaghetti. The big and HUGE difference is that spaghetti squash is a vegetable and there’s very little calories in the squash and it’s so much more healthy if you’re looking to cut down some calories. There’s way less starch than pasta but the flavors of the spaghetti squash are equally filling and satisfying to eat. Enjoy! Click Here for All Our–>  Spaghetti Squash Recipes are here for you to enjoy:

Spaghetti Squash Recipe with Sausage | Healthy Spaghetti Squash Recipe in a cast iron skillet

If you love Spaghetti Squash, you’ll probably love Spiralizing. Check out some Favorites for Spiralizing:

Nothing beats tried and true kitchen tools and cookbooks. Here’s some of the favorites:

Paderno Spiralizer

Paderno Spiralizer – The Classic! We’ve lost track of how many meals this one has made for us. Fantastic spiralizer.

KitchenAid Spiralizer Attachment on stand mixer

KitchenAid Spiralizer Attachment – Spiralize, peel, core, slice. All from the power of the KitchenAid stand mixer.

OXO Juliene Peeler

OXO Julienne Peeler – For those who love it simple. This great julienne peeler has seen a lot of mileage in our kitchen

Spaghetti Squash Recipe with Sausage | Healthy Spaghetti Squash Recipe @bestrecipebox

Spaghetti Squash with Sausage and Parmesan

There’s many ways to prepare the spaghetti squash. Microwaving is quicker, but we find that roasting or baking the squash in the oven gives more squash flavor. Both are still delicious. The recipe is written to roast and there is a note at the bottom of the recipe for microwave instructions.
5 from 1 vote


  • 1 Spaghetti Squash (about 3 pounds)
  • 2 Tablespoons (30 ml) Olive Oil , divided
  • 1 small Onion , chopped
  • 3 cloves Garlic , crushed or finely minced
  • 1 pound (454 g) un-cooked Italian Sausage
  • 1 Tablespoon (15 ml) finely chopped fresh Oregano (or 1 teaspoon dried oregano) – or whichever preferred herb
  • 1 cup (100 g) grated Parmesan cheese
  • Kosher Salt , to taste
  • fresh Cracked Black Pepper , to taste
  • optional – ( ) chopped Italian Parsley , for garnish
  • optional – red chili flakes


  • Preheat Oven to 375°F. Oil a sheet pan with 1 Tablespoon of olive oil.
  • Slice spaghetti squash in half lengthwise. (Kitchen tip: Use the tip of the knife to first pierce the squash to get the cut started. Once started, you don’t have to slice everything in half, just through the rind working around the diameter.) Scoop out the seeds and loose strands, then place cut side down on the prepared sheet pan.
  • Bake for 45 minutes, or until the squash flesh separates easily into strands with a fork. Using a towel to hold or wait until cool enough to handle, finish loosening the “spaghetti” from the shells and set aside.
  • Pinch the sausage into small balls. Set aside.
  • Heat a large sauté pan over medium heat. Heat remaining 1 Tablespoon of olive oil in pan, then add onion and garlic. Cook until soft, about 1 minute, then add sausage. Cook until bottom side of sausage starts to brown, then stir. Continue cooking and stirring occasionally until the sausage is cooked through (@ 2-3 minutes depending on heat and size of sausage).
  • Stir in the the oregano and then add spaghetti squash strands to the sausage. Continue cooking until spaghetti squash is heated through (usually less than a minute.)
    Remove from heat. Toss in Parmesan cheese.  Season with salt and pepper to taste. Garnish with desired optional parsley and/or red chili flakes. Serve immediately.


Note 1: Cooking the spaghetti squash in the microwave: Cut the squash in half and seed. Place cut side down in a microwave safe dish filled with 1-inch of water. Microwave on high until tender (about 10 minutes). See the post for more information: Microwaving Spaghetti Squash


Nutrition Information

Calories: 650kcal, Carbohydrates: 21g, Protein: 27g, Fat: 51g, Saturated Fat: 18g, Cholesterol: 108mg, Sodium: 1253mg, Potassium: 629mg, Fiber: 4g, Sugar: 7g, Vitamin A: 525IU, Vitamin C: 9.3mg, Calcium: 381mg, Iron: 2.8mg

More Spaghetti Squash Recipes