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Hot Sausage Stuffed Banana Peppers with Tomato Sauce and Melted Cheese (Gluten Free, Low Carb, Grain Free)

One of my favorite Italian restaurants offers a fabulous appetizer that I usually order as a meal. It consists of hot Italian sausage stuffed inside of sliced whole hot banana peppers sitting in a bath of tomato sauce and melted cheese topped off with fresh basil. I decided that the recipe was likely easy easy enough, so I tried to mimic it and it turned out great!

Keto Ingredients

Getting your sausage to the right consistency is key– simply putting ground sausage in a pepper doesn’t yield the soft consistency I needed. While I’m sure a traditional recipe uses breadcrumbs, I decided to use ground flax seed and a bit of almond flour to remove the wheat and lower the carbohydrate content.

These tasty peppers are sugar and gluten free. Leave the cheese off and they can also be dairy free. Use free range pork if you can, but if you can’t, a good quality ground sausage is important. If you can’t find regular ground hot Italian sausage, buy some links and squeeze the meat out of the casings. I like my food extra spicy, so I use hot peppers– but you can use mild peppers if you want less heat.

For the sauce, I used one I found (and love!) at Aldi. It’s the Priano brand basil tomato sauce. It’s only got 7 grams of net carbs per serving and has no sugars, preservatives or artificial ingredients of any kind. It also has big chunks of tomatoes in it, which are really delicious.


  • 2 large (5-6 inch) hot or mild banana peppers, raw, split down the middle and de-seeded
  • 1 T olive oil
  • 5 oz. ground hot Italian sausage (pork or chicken is fine)
  • 2 T ground flax seeds
  • 2 T almond flour
  • 1/2 tsp. Italian seasoning
  • 1 tsp. dried fennel
  • 1/2 cup no-sugar-added tomato sauce (I used Aldi Priano tomato basil sauce)
  • 1/4 cup water
  • 1/3 cup shredded provolone or mozzarella cheese
  • A few torn fresh basil leaves (optional)
  1. Preheat oven to 400 degrees and lightly grease a small casserole dish.
  2. In a medium bowl, combine sausage, flax seed, almond flour, fennel and Italian seasoning and work together with your hands until it is evenly mixed.
  3. Split the sausage into two equal portions and lightly stuff the banana peppers in the middle with the sausage mixture.
  4. Brush the outside of the peppers with olive oil.
  5. In a small bowl, combine the tomato sauce and water to create a thinner sauce. Spoon the sauce around the base of the peppers like a bath.
  6. Sprinkle cheese over the whole mixture.
  7. Place the casserole into the oven on the middle rack. Bake for about 20 minutes or until cheese is melted and sausage is cooked through.
  8. Turn oven to broil setting and broil for two more minutes two lightly brown the cheese and peppers. Top with fresh basil if desired.
  9. Serve. Yummy!
Nutrition (per pepper): 245 calories, 4 g carbs, 1 g fiber (3 g net carbs), 18 g fat, 16 g protein 

Need Ingredients for That Recipe?


It takes a lot of trial and error to find the "right" fit for a low carb recipe. I have made some ... different low carb desserts. You don't need to go through that! I made a list of my favorite ingredients as well as what stores you can find them at. Enjoy!

About the author

Leeann Teagno

Eating healthy, for me, is about more than weight loss like it used to be. It’s about controlling my blood sugar levels and obtaining normal–or relatively normal–hormone levels. I still struggle to lose weight efficiently, but eating a wheat, sugar and gluten free diet helps to control some of the problems I’ve encountered with these health issues of mine.


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