Keto Salisbury Steak
Published July 15, 2019 • Updated March 8, 2026
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My keto Salisbury steak is a one-skillet comfort meal where seasoned hamburger patties braise in a thick mushroom and onion gravy.
I started making this years ago when I wanted a filling, from-scratch dinner that tasted like the frozen TV dinners I grew up on, minus the flour. The patties are mixed with heavy cream and parmesan instead of the usual egg and breadcrumb binder, and that combination is what keeps them tender even after they sit in the braising liquid. One of my readers, Allison, told me she was hesitant about adding cream to the meat. She tried it anyway and said it kept the patties softer and moister than she expected. That tracks with what I’ve found after making this dozens of times.
Most versions of this dish use an egg plus almond flour or regular breadcrumbs to hold the patties together. I tested that approach early on and the result was denser, almost meatloaf-like. The cream and parmesan keep the texture lighter, and the parmesan adds a savory depth that an egg alone can’t match. If you’ve made my beef tips in mushroom gravy, this uses a similar braising logic, but the patties hold their shape better.
The gravy is the real reason I keep coming back to this recipe. I saute sliced onions and mushrooms in the same skillet where the patties browned, so all those pan drippings fold right into the sauce. A splash of red wine, some beef broth, a little arrowroot powder, and the whole thing thickens into a rich, savory gravy without any flour. I use arrowroot because it has roughly 7 times the thickening power of regular flour. Half a teaspoon does the job of two tablespoons, adding only 3 grams of carbs to the entire dish.
You’ll notice I don’t use Worcestershire sauce here. Most recipes include it, but between the red wine, tomato paste, and the fond from browning the patties, I get all the umami depth I need without it. I’ve tested batches with and without, and the version without lets the mushroom flavor come through cleaner. If you want it, a teaspoon in the gravy won’t hurt the macros.
This is one of those keto dinners I come back to on weeknights when my family wants real comfort food (not “healthy” comfort food, just comfort food). My boys don’t care that it’s low carb. They care that there’s gravy and they can put ketchup on it. The whole meal comes together in one skillet in about 30-35 minutes. If you like one-skillet ground beef meals, try my keto hamburger helper or skillet lasagna next. For something with more of a slow-braised feel, my shepherd’s pie uses a similar comfort food approach with a cauliflower top.
How to get tender patties and thick gravy
I mix the cream and parmesan into the ground beef with my hands, but I stop as soon as everything is combined. Overworking the meat makes the patties tough. Form them about 3/4 inch thick so they hold up during the braise without drying out. For the gravy, give the arrowroot powder a full 2 minutes in the pan with the tomato paste before adding liquid. That step cooks out the raw starch taste and gives you a smoother sauce.
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Ingredients
1 pound ground beef -
½ cup heavy cream
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½ cup shredded parmesan cheese
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4 tablespoons butter
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½ onion, sliced
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8 oz mushrooms, sliced
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1 tablespoon tomato paste
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½ teaspoon arrowroot powder
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1 cup chicken broth or beef broth
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¼ cup red wine
Step by Step Instructions
Step by Step Instructions
Mix ingredients
Mix together ground beef, cream, parmesan cheese, 1/2 teaspoon salt & 1/4 teaspoon pepper.
Form patties
Form 4 patties from the ground beef mixture.
Cook patties
Melt 2 tablespoons butter in a skillet over medium-high heat. Add patties and cook until browned on each side. (5 minutes per side)
Remove
Remove patties and set aside.
Saute mushrooms and onions
Melt 2 tablespoon butter in the skillet. Add onions and sauté onions until soft. Add mushrooms & 1/2 teaspoon salt.
Cook until evaporated
Cook until mushrooms release their fluid & most of it has evaporated.
Make sauce
Stir in tomato paste and arrowroot powder. Cook 1-2 minutes. Whisk in broth & wine. Bring to simmer.
Braise
Add patties back into the skillet, reduce to low heat and cook covered for 10-15 minutes.
Nutrition disclaimer
The nutrition information provided is an estimate and is for informational purposes only. I am a Doctor of Pharmacy (Pharm.D.); however, this content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult your physician or other qualified health provider before making any lifestyle changes or beginning a new nutrition program.
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Get My Macros + Recipes →Frequently Asked Questions
Does this recipe use Worcestershire sauce?
I don't include Worcestershire sauce in this recipe. Between the red wine, tomato paste, and the fond from browning the patties, I get plenty of umami without it. I've made batches both ways and prefer the cleaner mushroom flavor without Worcestershire. If you want to add it, a teaspoon mixed into the gravy works fine and adds less than 1g carbs.
Can I use ground turkey instead of ground beef?
I've made this with ground turkey and it works, but the flavor is milder and the patties are a bit softer. I add an extra tablespoon of parmesan to the turkey mixture to compensate. The gravy carries most of the flavor, so the swap is solid if you prefer turkey.
What can I use instead of heavy cream in the patties?
I mix the cream into the meat to keep the patties tender during braising. If you're out of cream, I've used a couple tablespoons of cream cheese worked into the beef and it does the same job. Unsweetened almond milk plus a tablespoon of coconut oil is another option I've tried, though the patties come out slightly less rich.
Do I need an egg or almond flour to bind the patties?
Most Salisbury steak recipes use an egg and breadcrumbs (or almond flour for keto). I skip both. The heavy cream and parmesan hold the patties together without making them dense. I tested the egg-and-almond-flour approach early on and the texture reminded me of meatloaf, not steak. The cream version stays lighter and more tender through the braise.
Can I make this in a slow cooker or Instant Pot?
I've only tested the stovetop and oven methods for this recipe. If I were adapting it for a slow cooker, I'd sear the patties and build the gravy on the stovetop first, then transfer everything and cook on low for 3-4 hours. For the Instant Pot, I'd use the saute function for browning, build the gravy in the pot, then pressure cook on high for 8-10 minutes with a natural release. I haven't dialed in exact times yet, so start conservative if you try it.
How do I make this dairy-free or Paleo?
I swap the heavy cream for coconut cream and drop the parmesan entirely (or use nutritional yeast if I have it). The butter in the skillet gets replaced with ghee or avocado oil. My dairy-free version still comes out with a thick, rich gravy because the arrowroot and broth do most of the work. If you're eating Paleo or Whole30, this version fits those frameworks too since there's no added sugar or grains.
Can I double the arrowroot powder for thicker gravy?
I use half a teaspoon, which gives a lighter coat on the patties. If you want thick diner-style gravy that really coats everything, use a full teaspoon. One of my readers, Roberto, tried doubling it and said the difference was real. I've confirmed the same in my own kitchen. A full teaspoon won't change the carb count by much (maybe 1-2 extra grams for the whole batch) and the gravy sets up nicely once you pull it off heat.
What's the best way to reheat leftovers without drying out the patties?
I reheat mine in a covered skillet over medium-low heat. The key is keeping the lid on so the gravy creates steam around the patties. It takes about 8-10 minutes. The microwave works in a pinch, but I cover the dish and add a splash of broth to keep things from getting rubbery. These leftovers reheat better than most of my ground beef recipes because the gravy protects the meat.
Don't touch the patties while they're searing. I kept nudging mine the first time and they fell apart on the flip. Let them release on their own and they hold together when you nestle them back into the gravy. Also switched to beef broth instead of chicken and the gravy came out noticeably darker and richer. Small change, real difference.
Third time making this and I finally cracked the gravy. I kept pulling it too early after adding the broth so it was coming out thin, but I gave it an extra five minutes to reduce and it's completely different now, thick enough to coat the patties. The parmesan mixed into the beef still gets me every time.
First time making this and the parmesan in the patty mix caught me off guard (I usually keep cheese out of the meat). They held together well and browned up evenly in the skillet. Four stars, would go lighter on the arrowroot next time since the gravy thickened faster than I expected.
I genuinely thought Salisbury steak was gone from my life when I went keto, and then that mushroom gravy hit and I cried a little.
That gravy gets me every time. The fond from searing the patties is what makes it taste like actual diner food.
Salisbury steak was the one thing I thought I'd permanently given up when I went keto. My mom made it every couple of weeks growing up and nothing came close. Made this on Sunday, and the moment I was sauteing the mushrooms and onions in that butter, the whole kitchen smelled like hers. Got a little emotional, honestly. The gravy is thick and clings to everything. Four stars only because I haven't tried the red wine version yet and I feel like that might be the unlock.
It is. Make it with the wine and see if it gets closer to hers.
Fourth time making this. Finally stopped skipping the red wine, and the gravy went from good to something I wanted to pour over everything on the plate.
Four times in before the red wine. That's the gravy the recipe was built around.
My wife and I just got back into keto after a few months off and found this while looking for something we'd actually want to eat during the week. I cook everything on Sundays to keep weeknights easy, so I'm trying to figure out if this works as a meal prep option. The gravy has me a little nervous. Cream-based sauces can get weird when you reheat them days later. Can I make the whole thing ahead and just reheat portions, or is it smarter to cook the patties and keep the gravy separate? Also not sure whether the arrowroot holds up after a couple days in the fridge or if it breaks down and gets watery. This is one of the more approachable keto recipes I've found so I really want to get the storage right.
Make it all together, one container. That half teaspoon of arrowroot is too small to break or get watery. Reheat covered on medium-low, 8-10 minutes, lid stays on the whole time.
Salisbury steak was the one comfort food I kept mourning when I started keto. Made this last week and when the mushroom gravy came together in the skillet I just stood there for a second. Tastes exactly like dinner at my grandma's house. Wasn't ready for that.
Grandma's is the hardest to match. That mushroom and onion combination is what does it for me.
Splash of Worcestershire while the mushrooms were softening and it changed everything. Already smelled great, but that one thing made it taste like it had been going for hours. Made the patties thicker too. The parmesan gives them this creamy center that holds everything together. Pull them earlier than you think. Mine dried out the first round, second time was perfect, and now I'm making this on rotation.
Worcestershire in the mushroom stage is smart. Not how I do it but clearly landed. Thicker patties hold up better through the braise too. Second batch always teaches you the timing.
Used beef broth instead of chicken and added a splash more red wine, and the gravy came out richer and darker than I expected. Tip for anyone who wants it thicker: give the arrowroot a couple extra minutes to work after you pull the heat, it sets up nicely.
Beef broth plus extra red wine gets you a completely different gravy. Darker, more savory. That's the version I make when I want it to feel like it simmered all day.
Cold Tuesday evening, wanted something that felt like actual comfort food. This delivered. The gravy is the thing. Mushrooms, onion, red wine all built in the same pan where you browned the patties, and every bit of that comes through. Freaking good. My only tweak: double the arrowroot powder if you want thick diner-style gravy that coats everything (what's listed is fine but the difference a full teaspoon makes is real). The parmesan mixed into the patties is now going into my regular burger recipe too. Didn't know I needed that combination.
The arrowroot tip is real. Half teaspoon gives you a lighter coat, full teaspoon is proper diner gravy. And yeah, parmesan in the beef is one of those things you can't un-know.
Planning to prep this on Sunday and reheat it Thursday for dinner. Should I make the whole thing and just reheat it in the pan, or cook the patties and make the sauce fresh that day? Not sure if the sauce will get weird sitting in the fridge for a few days.
Make the whole thing Sunday. The patties actually get better sitting in the gravy (they soak it up). Thursday is day 5 for me and I've done it, flavor holds. Reheat covered skillet on medium-low, lid on, about 8-10 minutes. The gravy won't get weird, the cream cooks out and it's mostly butter and broth at that point.
So yummy! My family just loved it! Thank you :)
My family too. The mushroom gravy is the part that gets them every time.
For me, the patties were like mush and REALLY hard to flip.
I'm sorry you had difficulty. It sounds like the patties didn't cook long enough on the first side before flipping.
We loved the flavors and the ease of preparing this. I was skeptical about adding cream to the meat, but it really worked to keep the burgers softer and moister. Used steak seasoning instead of salt and pepper in the burgers. Served it over mashed cauliflower which was great!
Never tried steak seasoning in the patties but that makes a lot of sense. Gets you garlic and pepper without measuring. Cauliflower mash is what I always serve this with.