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Spaghetti Squash with Vodka Sauce Casserole

This Spaghetti Squash with Vodka Sauce Casserole is the heartiest low carb comfort food. This creamy baked casserole is loaded with spicy Italian sausage and mushrooms, giving it tons of flavor. The “vodka sauce” is made with greek yogurt. Finished with a nice layer of mozzarella and fresh basil, this is my version of healthy.
Prep Time5 minutes
Cook Time1 hour 30 minutes
Total Time1 hour 35 minutes
Course: Main
Cuisine: Italian
Servings: 6 people
Calories: 511kcal
Author: Brianna May



  • 1 large yellow spaghetti squash about 4 pounds whole, halved & seeds removed
  • 1 Tablespoon olive oil
  • 1 pound ground spicy Italian sausage
  • 1 8 ounce container white mushrooms finely diced
  • 1 yellow onion diced
  • 5 cloves garlic minced*
  • 1 teaspoon salt
  • 5 cracks black pepper
  • 1 teaspoon dried thyme
  • 1 teaspoon dried oregano
  • ½ teaspoon red chili flakes*
  • ¼ teaspoon dried rosemary
  • 1 25 ounce jar tomato basil pasta sauce*
  • ½ cup plain greek yogurt*
  • 1 ounce (⅓ cup) parmesan reggiano grated
  • 6 ounces (1 ½ cups) mozzarella cheese, shredded
  • fresh basil for garnishing


  • Review all recipe notes and instructions before beginning.
  • Preheat the oven to 400 degrees.
  • On a baking sheet lined with parchment paper, brush all sides of the spaghetti squash with oil. Place each half squash cut side down.
  • Bake for 40-60 minutes, or until fork tender. While the squash bakes, in a large pot over medium high heat, cook the sausage and mushrooms. Let most of the water evaporate from the mushrooms.
  • Add the onions, garlic, and spices. Cook for 3-4 minutes or until the onion softens.
  • Add the sauce and simmer on medium low heat, stirring frequently until the squash is done. The sauce should thicken up a bit.
  • Once the squash is done, let it cool until you can handle it. Use a fork to scrape the middle of the squash so that the “spaghetti” forms.
  • Fold the squash, yogurt, and parmesan cheese into the meat sauce.
  • Lightly grease a 9 x 13 baking dish. Pour the squash mixture into the dish. Sprinkle the mozzarella cheese on top.
  • Bake for 15 minutes, or until the edges are bubbling and the cheese is completely melted. Let stand for 5-10 minutes before serving.


Spaghetti Squash: I highly recommend weighing the raw squash at the store or at home so that you have the correct amount. Spaghetti squashes vary in size. 
Onion: Swap for sweet or white onion. 
Red Chili: Omit if you do not want any spice. 
Tomato Sauce: Use an already seasoned jar of tomato sauce that has spices and olive oil already cooked into it. I prefer an herb flavored one. Avoid plain cans of tomato sauce. 
Greek Yogurt: I like to use 2%. You can use whatever fat content you prefer.
Use good quality italian pork sausage. Good quality sausage is made with lots of herbs and spices which will contribute a lot to the flavor of this dish. Pork sausage has more fat than other varieties, which also adds flavor and heartiness to the casserole. 
Use a vegetable chopper. I like to cut the veggies finely for this recipe. The smallest blade on this chopper works great! It is a huge time saver if you cut a lot in the kitchen. 
Cook off as much water as possible. The mushrooms and onions sweat (or release water) when they are cooked. You want to cook off all of this excess water because the spaghetti squash has a high water content as well. 
Simmer the sauce. Get to work on the sauce as soon as the squash goes in the oven so there is plenty of time for it to simmer and thicken. This is when all of the flavors develop and meld together. 
Watch the sauce. You want to keep an eye on the sauce and be sure to stir it so that it does not burn or stick to the bottom. 
Garnish with basil. For even more flavor and some freshness, finish the casserole with lots of fresh basil. 
Let the casserole stand. I like to let the casserole sit for 5-10 minutes when it comes out of the oven so it firms up a bit.


Serving: 1serving | Calories: 511kcal | Carbohydrates: 27g | Protein: 25g | Fat: 35g | Saturated Fat: 14g | Polyunsaturated Fat: 4g | Monounsaturated Fat: 15g | Trans Fat: 1g | Cholesterol: 84mg | Sodium: 1861mg | Fiber: 6g | Sugar: 13g