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Italian Sausage & Cauliflower Rice Stuffed Peppers {Paleo & Whole30}

Published . Last updated by 28 Comments

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What makes these Italian Sausage & Cauliflower Rice Stuffed Peppers different than the stuffed peppers our mothers made?

Paleo and Whole30 compliant, there’s no cheese, rice, or bread in this recipe but it’s loaded with flavor.

Red and orange bell peppers stuffed with sausage, cauliflower, and black olives, topped with caramelized onions and pistachios. Peppers are arranged in a white ceramic baking dish and serving spoon with garlic, carrots and cauliflower in the background.

Paleo, Whole30, Low-Carb, Gluten-Free, & Dairy-Free

If you’ve been around Savoring Today for along, you know I don’t follow or promote exclusive diets.

We established a healthy food philosophy for our family centered around meat and vegetables with full-fat dairy and sprouted grains.

This whole food approach, also known as clean eating, works for us, but I have a number of friends who suffer from food allergies or inflammatory diseases always looking for new, exciting recipes to better fit their dietary needs.

I’m here for you! And I think you’ll love this recipe!

Re-Creating old Favorites to Fit New Dietary Goals

We harness the natural sweetness of caramelized onions to balance the acidic quality of peppers (that’s what cheese usually does) and add the unique textural interest of pistachios.

These toppings help keep the stuffing from drying out (again, like cheese would) and bring the crispy-crunch you might be used to with breadcrumbs.

When modifying old favorites to fit new dietary goals, it’s important to consider the things you love most about what you are trying to replace to find a suitable and appealing substitute.

There are Paleo cheese recipes out there, but I cannot vouch for them since I’ve not tried any. However, you could easily adjust this recipe to include it before you add the onions and pistachios.

Using cauliflower as a rice substitute is one of the easiest ways to reduce carbs and incorporate more vegetables into your meal plans.

It’s become even easier with the availability of packaged “cauliflower rice”, but all you need is a box cheese grater.

Paleo Sausage & Cauliflower Rice Stuffed Bell Pepper Recipe with Caramelized Onion and Pistachio Topping

Mulay’s Sausage ~ Quality Always Makes a Difference

Finding quality sausage that is also Paleo and Whole30 compliant can be tricky because even health food store brands add sugar or soy.

I was delighted when Mulay’s Sausage generously provided a variety of sausage for us to try—I’m stoked to share my good fortune with you through this Italian Sausage & Cauliflower Rice Stuffed Pepper recipe.

Their sausage is All Natural, Antibiotic Free, Gluten Free, Sugar Free, Dairy Free and Soy Free—you’ll notice the quality in the first bite.

I am impressed with the clean pork flavor complemented by spices that don’t try to cover or mask. The chorizo is the best I’ve tried, balanced and flavorful with a hint of spice.

In this recipe, I used Hot Italian which I would describe as medium-mild in spicy heat. If you are the kick-it-up-a-notch type, I recommend their Killer Hot Italian instead.

Make-Ahead Easy Meal

The start to finish time might seem a little drawn out because of the baking time, but you can easily break it up by stuffing the peppers in advance and refrigerating for a couple of days until ready to bake.

The stuffing also freezes well, so you can mix up just that part of it and freeze until you’re ready to put it all together to bake—just keep the caramelized onion topping separate.

Got leftovers? Serve for breakfast with a sunny side up egg on top. Oh so good!

Stuffed red and yellow bell peppers topped with caramelized onions and pistachios in a white ceramic baking dish and serving spoon.

Paleo and Whole30 Compliant Sausage and Cauliflower Rice Stuffed Peppers
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Italian Sausage & Cauliflower Rice Stuffed Peppers: Paleo & Whole30

Bell pepper with Italian sausage and cauliflower rice stuffing topped with caramelized onions and pistachios. Paleo and Whole30 compliant.
Prep Time20 mins
Cook Time45 mins
Course: Main Dish
Cuisine: Italian
Servings: 4 -6 servings
Author: Judy Purcell

Ingredients

  • 2 large sweet onions (Viladia, Maui, or Texas Sweets) -- sliced thinly
  • 3 tablespoons extra-virgin olive oil -- as needed
  • 12 ounces  Mulay's Hot Italian Sausage
  • 1 cup diced carrots
  • 4 ounces mushrooms -- coarsely chopped
  • 3 cloves garlic -- minced
  • 28 ounces crushed tomatoes -- some of the sauce drained
  • 2 tablespoons tomato paste
  • 2 cups grated cauliflower -- about 1/2 pound
  • 2 teaspoons dried oregano
  • 1 teaspoon dried thyme
  • 1 cup sliced olives
  • 3 tablespoons chopped fresh parsley
  • 4 large sweet bell peppers
  • 1/3 cup shelled pistachios -- coarsely chopped just enough to create jagged edges
  • Sea salt and freshly ground pepper
US Customary - Metric

Instructions

  • Heat oven to 375°F. Heat 2 tablespoons of olive oil in a large skillet over medium heat, spreading the oil evenly over the pan. Add the sliced onions and stir to coat the onions with the oil.
  • Continue to cook onions over medium heat, about 10 minutes, stirring occasionally. Season with 1/2 teaspoon of salt and spread onions out evenly in the skillet, reduce heat to low.
  • Allow onions to caramelize, stirring occasionally, while preparing the rest of the dish, about 35 minutes.
  • In another skillet, brown the sausage, breaking up into bite-size pieces as it cooks. Transfer to a plate and set aside.
  • In the same skillet, cook the carrots and mushrooms in the rendered fat over medium heat 5 to 6 minutes. Stir-in the garlic, tomatoes, and tomato paste; cook for 2 more minutes.
  • Add the grated cauliflower to the skillet with the oregano and thyme; cook for 2 minutes, then transfer to a large bowl. Salt and pepper, to taste. Remove the onions from the skillet and set aside 2/3 cup for topping.
  • Chop the remaining onions and toss with the cauliflower mixture, sausage, olives, and parsley until well combined.
  • Slice the bell peppers in half and remove seeds. Brush the outside of the peppers with a thin coat of olive oil and lightly season the inside with salt and pepper.
  • Fill the peppers with the stuffing and sprinkle with pistachios. Pour 1/4 cup of water in the bottom of the pan and bake for 20 minutes. Remove from the oven and top with the caramelized onions, as desired.
  • Continue to bake an additional 20 to 25 minutes, or until peppers are tender and onions are golden brown.

Notes

The caramelized onions and stuffing can be made and mixed days in advance. Peppers can be stuffed up to 24 hours in advance.

Nutrition

Calories: 694kcal | Carbohydrates: 48g | Protein: 23g | Fat: 48g | Saturated Fat: 12g | Cholesterol: 64mg | Sodium: 1532mg | Potassium: 1833mg | Fiber: 13g | Sugar: 27g | Vitamin A: 10050IU | Vitamin C: 214.9mg | Calcium: 207mg | Iron: 6.7mg
Learn how to make this and all recipes even easier!Check out our Monthly Meal Prep System!

More Paleo Recipes You’ll Love:

A stuffed red bell pepper topped with caramelized onions and pistachios on a white plate with a fork. Pan of stuffed peppers in the background.

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  1. Elizabeth says

    5 stars
    Delicious recipe! I made a few substitutions based on my preferences: zucchini instead of mushrooms & olives and Italian seasoning instead of oregano. I was skeptical of the pistachios, but they added a nice crunch and a bit of flavor. Will make this recipe again!

    Reply

  3. Pam says

    My hubby surprised me with your recipe last night. He sub’d ground beef in lieu of Italian sausage and used slivered almonds (didn’t want to shell pistachios). It was delish! Next time will use the pistachios. Thank you!

    Reply

    • Judy Purcell says

      Hi Pam, thank you for stopping in to let me know how much you liked it–feedback is so helpful. I love it when someone surprises me with food! Ha! What a sweet man you’ve got there. I think you’ll love it with the pistachios too. 🙂

      Reply

    • Judy Purcell says

      Hi Pam, yes you can sub hamburger for the Italian sausage and add dried basil, crushed fennel seed, and a little extra salt to bring the Italian sausage flavor to it. Since you’re browning the meat you can add a teaspoon of the dried basil and fennel and 1/2 teaspoon of salt, taste, then adjust as needed. 🙂

      Reply

  8. Monique says

    These look so yummy! I’ve always wanted to try making stuffed peppers and I love the idea of making them with cauliflower rice to up the veggie content even more. Great tip on covering with onion to balance out the flavour!

    Reply

  18. April J Harris says

    5 stars
    Judy, this is such a colourful, flavourful and delicious sounding recipe – and it’s so wholesome too! I’m really taken with it and look forward to giving it a try when we get home from our travels. Scheduled to share on the new look Hearth and Soul Facebook page later today. Thank you so much for sharing with the Hearth and Soul Link Party! I hope you will visit again this week, and let me know what you think of the new look logo!

    Reply

  21. mjskitchen says

    I’m on a “good food” diet and this dish would fit right in, 🙂 My diet requires flavor, texture and good healthy ingredients, everything you’ve put into these peppers. Fabulous stuffed peppers! I’ve never tried “ricing” cauliflower, so maybe it’s time I tried. Thanks Judy for such a great dish!

    Reply
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