This keto Salisbury steak braises tender seasoned patties in a thick, savory mushroom and onion gravy — 5.5g net carbs and 31.1g protein. One skillet does the whole comfort meal.
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.
Why I use arrowroot powder for the gravy
Traditional gravy gets thickened with flour or cornstarch. Both are too high in carbs for a keto diet.
Arrowroot powder
I use arrowroot powder as my go-to thickener for this dish. It has 7x the thickening power of regular flour, so a little goes a long way. Most gravy recipes call for two tablespoons of flour, which adds 12 grams of carbs. I use half a teaspoon of arrowroot powder instead, and only 3 grams of carbohydrates go into the entire dish. I use the same thickening approach in my chicken and rice soup when I need body without changing the flavor.
A lot of recipes default to xanthan gum for thickening. I’ve tried it in this gravy and the texture goes slimy if you add even slightly too much. Arrowroot is more forgiving, and it gives the sauce a cleaner, more traditional body. If you don’t have arrowroot on hand, 1 tablespoon of coconut flour works as a backup (slightly grainier, but it gets the job done).
Choosing a low-carb red wine
This recipe calls for red wine in the gravy. I add it because it deepens the flavor of the mushroom sauce, but you can skip it and add extra broth if you prefer.
Most dry red wines are fine on keto. I reach for pinot noir (3.4g carbs per 5 oz.) or cabernet sauvignon (3.8g carbs per 5 oz.) because they’re the lowest carb options I’ve found. I keep a bottle in the pantry specifically for cooking.
What I serve with this
The mushroom and onion gravy is the whole reason to pick the right side dish. I want something the gravy can soak into. My go-to is mashed cauliflower or twice-baked cauliflower mash. Cauliflower rice, zucchini noodles, shirataki noodles, asparagus, and broccoli all work too. If you want a full plate, serve the patties alongside beef and broccoli for a double-protein night, or swap the braised concept entirely and try my Philly cheesesteak casserole.
Make-ahead, storage, and freezer tips
I get asked about meal prepping this one a lot. Here’s what I’ve found works best.
Fridge storage: The cooked patties in gravy keep in an airtight container for 3-4 days. I actually think they taste better the next day because the flavors settle into the meat overnight.
Make-ahead strategy: If you’re prepping on Sunday for a Thursday dinner, I’d make the whole thing and store it assembled. The patties reheat better when they’re sitting in the gravy, not dried out on their own. Warm it in a covered skillet over medium-low heat until the sauce starts to bubble.
Freezer tips
Freeze the uncooked patties alone and thaw them when you want to continue with the rest of the recipe.
Or freeze the cooked patties in the mushroom and onion gravy. Thaw in the refrigerator overnight and simmer in a skillet until warmed through.
I prefer freezing them in the gravy. The sauce protects the patties from drying out in the freezer, and everything reheats in one pan.
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.
Cook until mushrooms release their fluid & most of it has evaporated.
7
Make sauce
Stir in tomato paste and arrowroot powder. Cook 1-2 minutes. Whisk in broth & wine. Bring to simmer.
8
Braise
Add patties back into the skillet, reduce to low heat and cook covered for 10-15 minutes.
Nutrition
Per serving: 1 patty (1/4 pound)
Calories
500
Fat
37.9g
Protein
31.1g
Total carbs
6.8g
Net carbs
5.5g
Nutrition is an estimate calculated from the ingredients listed. Brands vary, so check labels if you track closely.
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.
If you’re making this for a sit-down dinner, keep the patties and gravy separate until you plate. The gravy holds fine on low. Patties straight from the skillet are a completely different thing than ones that absorbed liquid for 20 minutes. I made this for a dinner last month and served it that way. What I didn’t anticipate was how many people went back to the pot for more gravy on their second round rather than take a second patty. One guest who doesn’t do keto stopped partway through and asked what I put in the sauce. I told her chicken broth, red wine, the reduction. She pointed at the patties and asked if there was dairy in the meat too. She’d picked up on the cream without knowing it was there. That’s not nothing.
My sister wants a homemade birthday dinner next weekend and this is the first thing I thought of. Doubling for 8, do I double the arrowroot too or will the gravy get weirdly thick? Also debating whether 8 patties can realistically fit in one skillet or if I should just do batches.
The parmesan in the patty mix had me nervous. I once threw together a cheesy meatball situation that went rubbery and wrong. Kept expecting that here. But they held together and the parmesan kind of disappears into the meat, you just get a richer, denser patty than a plain beef mix. My old breadcrumb version never had that depth. Four stars, not five, because I over-seasoned mine on the first run, but that’s not the recipe’s fault.
You had good reason to be nervous, Rhonda. I’ve had cheesy meatballs turn rubbery on me too. The parmesan behaves in this one because it goes in with the cream and melts into the beef instead of pooling out. Four stars with an honest note about your own seasoning is a fair trade.
Wasn’t sure a one-skillet recipe would hold up as a sit-down dinner main. I made this for six people and someone stopped mid-meal to come back to the kitchen just to ask what was giving the gravy that depth. It’s the tomato paste. Barely any of it but it does something the broth alone wouldn’t. Four stars because I’d pull the patties about a minute sooner next time, but the gravy more than makes up for it.
One pound doesn’t stretch to six without going thicker or running a second batch, and thicker takes the extra minute. Probably what you hit. Hope round two works out, Kelly.
My husband never asked for a starch on the side, which surprised me. Afterward he wanted to know what made the gravy taste different. I’m blaming the tablespoon of tomato paste, and I’d double it next time.
My son won’t go near mushrooms but he cleaned his plate without a single question. The gravy hides everything. Would definitely make more of it next time.
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.
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.
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.
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.
