Keto Sausage Breakfast Casserole

Annie Lampella @ Ketofocus

By Annie Lampella, Pharm.D.

Published January 1, 2021 • Updated March 14, 2026

Reader Rating
4.7 Stars (19 Reviews)

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My go-to keto breakfast casserole with sausage, eggs, cheddar, and a coconut flour trick that gives it a bread-like texture for clean slicing. 2.3g net carbs, 24g protein, and I make a batch every Sunday for the week.

This sausage breakfast casserole is my go-to when I need to feed a crowd or want to prep breakfast for the entire week in one pan. Instead of cooking eggs and sausage separately every morning, I throw everything together with cream, cheese, and a few other ingredients for a filling one-pan breakfast that takes about 30 minutes start to finish.

The secret ingredient is a small amount of coconut flour. Most keto egg casseroles end up with a purely eggy texture that falls apart the second you try to slice it. The coconut flour absorbs moisture and gives this casserole a bread-like structure, so each piece holds together for easy portioning. I tested this side by side with oat fiber and got the same structural hold with zero coconut taste, so if you are not a fan of coconut flavor, swap in 2 tablespoons of oat fiber instead.

keto breakfast casserole on stacked plates with a glass of milk

I make a batch of this every Sunday night. In the morning, I pull out a square, warm it up for 90 seconds in the microwave, and breakfast is done. At 389 calories and 24g protein per slice, it actually keeps me full until lunch, which is more than I can say for most grab-and-go breakfasts. If you want something even more protein-heavy in the same make-ahead format, try my high protein breakfast casserole.

One thing I love about this recipe is how forgiving it is. A reader named Maria swapped the sausage for chorizo and added a small can of diced green chiles (extra moisture from both the meat and the peppers), and the coconut flour still held everything together for clean slices. Her husband took one bite and asked where she ordered it. That moisture tolerance is what separates this from most egg bakes, which fall apart the minute you add anything wet.

The green onions add a nice brightness against the rich sausage and cheddar, and the whole thing comes together in one bowl plus a baking dish. If you want to round out the morning, pair it with a keto ham frittata for a brunch spread, or keep it simple with fresh berries on the side.

How to make keto breakfast casserole

Making a low carb breakfast casserole is straightforward, and one batch gives me breakfast for the entire work week with about five minutes of morning effort.

  1. Cook the sausage. Brown breakfast sausage in a skillet over medium-high heat, breaking it into crumbles. Drain any excess grease thoroughly. This step matters more than you think. I had a reader who skipped draining, baked it for 34 minutes, and the center still would not set. The grease pools at the bottom and prevents the egg mixture from firming up, no matter how long you bake it.
  2. Whisk the egg mixture. In a large bowl, whisk eggs, heavy cream, coconut flour, salt, pepper, baking powder, green onions and most of the shredded cheddar.
  3. Combine and pour. Stir the cooked sausage into the egg mixture, then pour everything into a greased 9×13 baking dish. Scatter the remaining cheese on top.
  4. Bake at 350 degrees Fahrenheit for 20 to 28 minutes, or until the center springs back when you gently press it.

Close up of an egg, sausage casserole topped with cheese.

Key ingredients and substitutions

This recipe uses simple pantry staples, and I have tested most of these swaps myself.

  • Sausage. Any ground sausage works: breakfast sausage, Italian, or sliced kielbasa. Turkey sausage is a solid lighter option (a reader tested it and said the coconut flour held the texture together better than she expected). Crumbled bacon or chopped ham work too. If you like that sausage-cheese combination, my keto sausage balls use a similar base.
  • Eggs. Six whole eggs create the base. I have added up to 10 for a fluffier result (just add a few extra minutes of bake time). Egg whites work if you want to cut fat and calories.
  • Heavy cream. Gives the richest flavor. Unsweetened almond milk or coconut milk can substitute if you want a lighter or dairy-free version. One of my readers swapped in blended cottage cheese and the protein jumped to 31g per serving at nearly identical calories.
  • Coconut flour. This is what gives the casserole its bread-like hold. Without it, you get a looser, purely egg-based texture. If you prefer to skip coconut flavor, use 2 tablespoons of oat fiber instead. I tested both and they perform the same structurally.
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Keto Sausage Breakfast Casserole

4.7 (19) Prep 10m Cook 20m Total 30m 8 servings

Ingredients

  • 1 tablespoon olive oil
  • 1 pound ground sausage
  • 6 eggs
  • ½ cup heavy whipping cream
  • ¾ teaspoon salt
  • ½ teaspoon pepper
  • ⅓ cup coconut flour or 2 tablespoons oat fiber
  • 1 teaspoon baking powder
  • 3 green onions, sliced
  • 8 oz shredded cheddar cheese

Step by Step Instructions

Step by Step Instructions

1
Preheat oven

Preheat oven to 350 degrees F and grease a medium casserole dish with butter or cooking spray.

350 degree oven
2
Cook sausage

Over medium-high heat, cook olive oil and sausage in a large skillet until the sausage is cooked through. Remove from the heat and set aside to cool slightly.

cooking ground sausage in a skillet next to other ingredients
Tip No need to drain the oil; however, you can for a lower calorie option.
Ingredients for this step
  • 1 tablespoon olive oil
  • 1 pound ground sausage
3
Whisk & mix

Whisk together eggs, heavy cream, salt and pepper into a large bowl. Add in coconut flour, baking powder, green onions and shredded cheddar cheese (reserving about ½ cup for the topping). Mix until combined.

whisking a mixture of egg, cheese and green onion
Ingredients for this step
  • 6 eggs
  • ½ cup heavy whipping cream
  • ¾ teaspoon salt
  • ½ teaspoon pepper
  • ⅓ cup coconut flour or 2 tablespoons oat fiber
  • 1 teaspoon baking powder
  • 3 green onions, sliced
  • 8 oz shredded cheddar cheese
4
Stir & spread

Stir the cooked & cooled sausage to the egg mixture. Spread into the casserole dish. Top with remaining ½ cup of shredded cheddar cheese.

cheddar cheese sprinkles on top a casserole dish
5
Bake it

Bake at 350 for 20-28 minutes or until the casserole is golden brown on top and the center is set.

placing down a hot cheesy breakfast casserole
Nutrition Per Serving
389 Calories
30.1g Fat
24.2g Protein
2.3g Net Carbs
4g Total Carbs
8 Servings
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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Keto Sausage Breakfast Casserole

Frequently Asked Questions

Can I add vegetables to this casserole?

I add veggies all the time for extra flavor and nutrition. Stick with low-moisture vegetables like broccoli, asparagus, or spinach (give spinach a quick wilt in the pan first). Higher-moisture vegetables like cauliflower, zucchini, and mushrooms need to be sauteed first to cook off the liquid, otherwise the casserole turns out watery. I have also tried diced bell peppers and they hold up fine as long as you saute them for a few minutes.

Can I use turkey sausage instead of pork?

Yes. I have had readers test this and report back that the casserole held together even better than they expected. Turkey sausage has less fat than pork, so you will not need to drain as much grease. The coconut flour does the structural work regardless of which protein you use. Just make sure your turkey sausage is well-seasoned, since pork sausage has more built-in flavor.

Why won't the center of my casserole set?

Almost every time I hear this, the answer is undrained sausage grease. One of my readers baked his for 34 minutes and the center still would not firm up. The fix was simple: drain the grease thoroughly after browning the sausage. That excess fat pools at the bottom and prevents the egg mixture from setting, no matter how long you bake it. If you drained well and it is still jiggly, give it another 3 to 5 minutes and check again.

How do I tell if my egg casserole is done cooking?

I gently press the top center with my finger. It should spring back firmly without jiggling. For precision, use a food thermometer and look for 160 degrees Fahrenheit in the center. Mine usually takes 22 to 25 minutes, but ovens vary.

Can I make this the night before?

Yes, and I actually prefer it this way for weekday mornings. Assemble the full recipe in your baking dish, cover tightly with plastic wrap, and refrigerate for up to 24 hours. I pull it out about 30 minutes before baking so it comes closer to room temperature, then bake as directed. The timing stays about the same, but you may need an extra 2 to 3 minutes since it starts cold.

Can I make this casserole dairy-free?

I have made it with unsweetened almond milk in place of the heavy cream, and it works. The casserole is a little less rich, but the coconut flour still gives it that bread-like hold. For the cheese, I have not found a dairy-free shred that melts the same way, so I skip it entirely and add extra green onions and a pinch of nutritional yeast for savory depth. It is a different dish at that point, but still good for a keto dairy-free option.

What size baking dish do I need for this casserole?

I use a 9x13 inch baking dish for an even layer that cooks through in 20 to 28 minutes. You can also use a 9x9 dish for a thicker casserole, but add 5 to 8 minutes to the bake time and check the center with a thermometer. My smaller 8x10 dish works too.

Can I substitute Greek yogurt or cottage cheese for heavy cream?

Yes. One of my readers ran the full macro comparison in Cronometer and the results surprised me. Swapping heavy cream for blended cottage cheese bumped protein from 24g to 31g per serving at nearly identical calories. Net carbs go up a bit (about 5g vs 2.3g), so it depends on your priorities. I have tried the cottage cheese version and the texture is slightly denser but still slices cleanly.

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A cheese covered casserole in a white dish with forks nearby and a slice on a plate.

Easy ways to customize this casserole

Besides sausage, egg, and cheese, I use this recipe as a base for dozens of different flavor combinations. Here are the ones I have actually tested or had readers confirm.

Mix up the proteins

  • Instead of sausage, try bacon, ham, or pepperoni for a completely different flavor. A reader named Kristen skipped the sausage entirely, went Denver omelette style with ham, bell peppers, and bacon, and said it held together just as well for meal prep slicing.
  • In place of whole eggs, use egg whites for a lower fat, lower calorie option.

Add vegetables

  • Green onions are in the base recipe for brightness and color, but I add other vegetables all the time.
  • Low-moisture vegetables like broccoli, asparagus, or spinach work best. Give spinach a quick saute until just wilted before stirring it in. I have been meaning to build a dedicated spinach version since that combination keeps coming up in reader requests.
  • Higher-moisture vegetables like cauliflower, zucchini, tomatoes, and mushrooms need to be cooked first with the excess liquid drained. Otherwise the casserole turns out watery.

High-protein variation

One of my readers (Julie) ran the numbers on swapping heavy cream for blended cottage cheese or Greek yogurt. Protein jumped from 24g to 31g per serving at nearly identical calories. Net carbs go up a bit (about 5g vs 2.3g), but if you are chasing protein, that is a real trade worth making. I use this swap when I know I will be training that morning.

Use different cheeses

  • Besides cheddar, try pepper jack, Colby jack, or Monterey jack for a different flavor.
  • Crumbled cheeses like goat cheese, feta, or cream cheese also work well. Dot them across the top before baking for pockets of melted cheese throughout. Julie’s Greek version with feta and sun-dried tomatoes is low carb comfort food at its best.
A slice of breakfast egg casserole on a stack of plates in front of milk.

Storage and meal prep

Meal prep and reheating

The best part about this recipe is that it works as true make-ahead breakfast. I bake it on Sunday, and I have grab-and-go keto breakfast squares for the entire work week.

To prep ahead without baking, assemble the casserole in your baking dish, cover tightly with plastic wrap, and refrigerate for up to 24 hours. I pull it out about 30 minutes before baking so it comes closer to room temperature, then bake as directed.

Once baked, cut the casserole into 8 squares. Each morning, I pull out a square and reheat in the microwave (90 seconds), oven (350 degrees for 8 to 10 minutes), or air fryer (350 degrees for 4 to 5 minutes). If you want more variety in your meal prep rotation, my Mexican breakfast casserole uses the same prep-ahead approach with a Southwestern twist.

Refrigerator storage

I store leftover casserole in an airtight container in the refrigerator for up to 4 to 5 days. The texture actually holds up better than most egg-based dishes because of the coconut flour.

Freezer storage

Wrap individual squares tightly in plastic wrap, then place them in a freezer bag. They keep well for up to 3 months. I thaw mine overnight in the refrigerator before reheating. The texture is best within the first month, but they are still perfectly good after that.

More make-ahead keto breakfast recipes

If you like this casserole approach to breakfast, here are a few more recipes I use that follow the same make-it-once, eat-all-week strategy.

About the Author
Annie Lampella, Pharm.D.

Annie Lampella, Pharm.D.

Annie is a Doctor of Pharmacy, mom, and the recipe creator behind KetoFocus. With a B.S. in Genetics from UC Davis, she has over 14 years of experience developing family-friendly keto recipes based on the science of human metabolism.

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Reviews 47
4.7 Stars (19 Reviews)
  1. K
    Kelly Apr 19, 2026

    Letting it rest 10 minutes after coming out of the oven changed everything for me. Slices come out clean instead of crumbling at the edges. Took me three batches, won't skip it again. I also started throwing diced jalapeños in with the green onions and it just lifts the whole thing, gives it this slow heat that makes me actually look forward to getting up on Monday. The coconut flour texture surprised me too, almost bread-like, and I was genuinely not expecting that from a breakfast casserole. Only note: bake time ran short in my oven, needed closer to 28 minutes to get fully set, so watch for the golden color on top rather than going by time alone. Double batch next week, I already know.

  2. T
    Tamika Apr 10, 2026

    I've made this six or seven times now, always on Sundays for the week ahead. Last batch I tried the oat fiber option instead of coconut flour and the texture shifted noticeably, more custardy through the center and less dense. Both reheat fine but the oat fiber version slices cleaner after a night in the fridge. Worth trying if you have it.

  3. S
    Samantha Apr 6, 2026

    My son has been on a cereal kick for years and I've basically stopped trying to get him to eat a real breakfast before school. Made this on Sunday for my own meal prep and didn't think much of it. Monday morning I found him at the microwave at 6am heating up a slice, and when I asked him what he thought he said 'it's like a bread thing but with meat in it.' The coconut flour actually surprised me -- it holds together like actual baked bread instead of falling apart like most egg casseroles. I've made plenty of frittata-style dishes that taste fine but always feel like a side dish, and this one doesn't. Filling enough to actually be breakfast. Already doubling it next week so we don't run out by Wednesday.

    1. Annie Lampella
      Annie Lampella Apr 9, 2026

      'A bread thing with meat in it.' Nails it. The coconut flour is why I kept tweaking that recipe, most egg casseroles just don't have that structure.

  4. D
    Dani A. Apr 4, 2026

    Made this Sunday and it kept falling apart when I sliced it (the flavor was so good though), not sure if I just underbaked it or measured the coconut flour wrong?

    1. Annie Lampella
      Annie Lampella Apr 6, 2026

      Probably underbaking. Press the center before you pull it , if it jiggles at all, put it back in. Coconut flour can throw it off too if it was packed instead of spooned level, but I would check the bake first.

  5. N
    Natalie Anderson Mar 30, 2026

    Brought this to a neighborhood brunch and it was gone before the regular quiche. Nobody at the table even knew it was keto. The way it slices so cleanly (I credit the coconut flour) made it look like something from a catering spread. I'd bump up the green onions next time, but the texture holds up well for a crowd.

    1. Annie Lampella
      Annie Lampella Apr 2, 2026

      Gone before the quiche. Yes. More green onions is smart, I throw in the whole bunch when it's for a crowd (more than the recipe calls for, but no one notices).

  6. C
    Crystal Mar 27, 2026

    Started keto in January and thought Sunday casseroles were just gone from my life. The kind you make a big batch of, the house smells like sausage all morning, and you eat on it through the week. This brought that back. The coconut flour is what makes it work, gives it a texture most egg bakes never get close to, slices clean every time. Seven Sundays in a row now. 2.3g net carbs and 24g protein per serving, and I feel like I got something back I thought I'd given up for good. That hit harder than I expected.

    1. Annie Lampella
      Annie Lampella Mar 30, 2026

      Seven Sundays in a row is the whole goal. I usually make a double batch the last week of the month just so I'm not scrambling.

  7. R
    Rebecca Mar 26, 2026

    The coconut flour addition had me skeptical (I've made egg casseroles that turn into a soggy mess the second you try to slice them). This one cut cleanly into squares and held together. Better than the three other breakfast casseroles I've been rotating through.

    1. Annie Lampella
      Annie Lampella Mar 30, 2026

      Clean slices were the whole point of adding it. Every egg casserole I made before that step did exactly what you described.

  8. R
    Ray Mar 23, 2026

    The coconut flour trick does something I didn't expect. You actually get clean slices, not just egg scramble falling apart in the dish. Been making it every Sunday for three weeks. My one note: the sausage brings enough salt that I'd pull back to half a teaspoon instead of three-quarters. Not a dealbreaker, just something I dialed in after the second batch. 24 grams of protein per serving is what has me locked in.

    1. Annie Lampella
      Annie Lampella Mar 25, 2026

      The salt note makes sense. Fattier sausages run saltier, so half a teaspoon works. Three Sundays locked in is the goal.

  9. A
    Aaliyah Mar 14, 2026

    Used turkey sausage instead of regular because it was all I had, figured it would come out kind of flat, but the coconut flour really holds everything together and the flavor came through way more than I expected. Trying it with jalapeños next time.

    1. Annie Lampella
      Annie Lampella Mar 16, 2026

      Turkey sausage has less fat to drain, so the coconut flour can actually set it up clean. Jalapeños are a natural here. Those green onions plus the heat is going to be so good.

  10. D
    Dina T. Mar 10, 2026

    Was bracing for scrambled egg mush when I cut into it but it came out in actual clean squares and I just stood there for a second (coconut flour skeptic, officially converted).

    1. Annie Lampella
      Annie Lampella Mar 12, 2026

      Ha, that pause. The coconut flour has one job here, binds it so it cuts clean instead of falling apart. 1/3 cup in the whole casserole.

  11. M
    Maria Feb 18, 2026

    I swapped the ground sausage for chorizo and added a small can of diced green chiles. Was a little unsure how the extra moisture would affect the texture, but the coconut flour held everything together just fine for slicing. My husband took one bite and asked where I'd ordered it from, which was the biggest compliment. Already planning to try it with pepper jack next Sunday.

    1. Annie Lampella
      Annie Lampella Feb 18, 2026

      Ha, 'where'd you order that' is the whole goal. Chorizo with green chiles is a straight upgrade honestly. Pepper jack next Sunday sounds right.

  12. J
    Julie Heck Aug 11, 2025

    For a better comparison, I adjusted my nutrition info to match your serving size

    Servings: 8
    Amount Per Serving (calculated by Cronometer)

    Version : Original // Greek
    Calories : 389 // 387
    Fat : 30.1g // 25.7g :
    Protein : 24.2g // 31.4g :
    Total Carbs : 4g // 5.8g
    Net Carbs : 2.3g // 5.3g

    1. Annie Lampella
      Annie Lampella Aug 16, 2025

      Greek yogurt for the cream bumps the protein that much? I might actually try that. The carbs go up a bit but 31g protein is solid.

  13. J
    Julie Heck Aug 11, 2025

    I LOVE this recipe!
    It's so versatile and satiating.

    To get more protein and trim some calories I used these variations : I swapped sausage for hamburger, and use blended cottage cheese instead of heavy whipping cream, swapped coconut flour for whey protein powder and egg white powder, swapped cheddar for feta, and added 6 more eggs. This is the perfect start to my day. 1 minute in the microwave and I've got the perfect Keto breakfast or lunch.

    This is my latest variation:
    Greek with sun dried tomatoes and feta. It's addicting! And 42g protein too!

    6 large servings
    Calories : 516
    Protein : 41.8 (*35%* Keto Macros)
    Total Carbs : 7.8g
    Fiber : 0.7g
    Net carbs : 7.0g (*5%* Keto Macros)
    Fat : 34.3g (*60%* Keto Macros)
    Choline : 364mg
    Potassium : 547mg
    Selenium : 51mcg
    Calcium : 323mg

    Ingredients:
    1 lb browned hamburger
    60g (4 Tbps) Girard's Greek Salad Dressing
    55g sun dried tomatoes
    12 eggs
    83g Cottage Cheese (blended)
    96g feta (crumbled)  
    20g Whey Protein Powder (unflavored)
    10g Egg White Protein Powder
    2 tsp Baking Powder

    Sprinkle these on top AFTER it's been baked
    30g (2 Tbps) Greek Salad Dressing
    42g feta (crumbled)

    Directions:
    Toss together hamburger
    and 60g (4 Tbps) Girard's Greek Salad Dressing

    Chop sun dried tomatoes and add it to the hamburger. Grease the bottom of the 9x13 with the oil from the sun dried tomatoes

    Beat eggs

    Then add all other ingredients to the eggs and mix to combine

    Pour mixture into 9x13

    Bake @ 350° for 25-30 minutes

    When it comes out, let cool 2 min then
    Brush on top ...
    30g (2 Tbps) Greek Salad Dressing
    Sprinkle on top
    42g feta (crumbled)

    1. Annie Lampella
      Annie Lampella Aug 14, 2025

      Greek yogurt for the cream bumps the protein that much? I might actually try that. The carbs go up a bit but 42g protein is solid.

  14. J
    Joanie Thomas Jun 5, 2025

    Could you substitute ground beef for sausage? If so, would anything need to be done differently? Thank you!

    1. Annie Lampella
      Annie Lampella Jun 5, 2025

      Yes! Ground beef works great here. Since sausage is already seasoned, you'll want to add spices to the beef - garlic powder, onion powder, and sage give you that breakfast sausage flavor. Crushed red pepper adds nice heat if you like a kick.

  15. C
    Chris Jun 11, 2024

    Recipe looks great! What size baking dish do you use?

    1. Annie Lampella
      Annie Lampella May 13, 2025

      I use a smaller 8x10 or 11 dish, but you can use a 9x13. Any size will work.

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