This creamy sausage stuffed spaghetti squash features roasted squash halves filled with browned Italian sausage, wilted spinach, and a rich Tuscan-style cream cheese sauce infused with tomatoes and Parmesan. It's a low-carb, vegetable-forward main that delivers restaurant-quality comfort.
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Dice the red onion and halve the baby tomatoes.
In a large skillet over medium-high heat, cook the Italian sausage, breaking it up with a spatula, until browned and cooked through.
Remove the cooked sausage from the skillet and set aside on a paper towel-lined plate.
In the same skillet, add the diced onion and halved tomatoes. Cook for 2-3 minutes, until the onions are soft and the tomatoes begin to blister.
Add the cream cheese and chicken broth to the skillet. Stir continuously until the cream cheese has melted into a smooth sauce.
Stir in the grated Parmesan cheese until well combined.
Season the sauce with Italian seasoning, garlic powder, onion powder, salt, black pepper, and optional red pepper flakes.
Add the baby spinach to the skillet and stir until it has wilted into the sauce.
Return the cooked sausage to the skillet and stir to combine everything.
Spoon the creamy sausage mixture into cooked spaghetti squash halves. Top with additional Parmesan cheese if desired and serve immediately.
Store the sausage filling in an airtight container for up to 4 days; reheat gently in a skillet over medium heat and serve over freshly roasted squash. Freeze filling only for up to 3 months.
Yes. Prepare the sausage filling up to 2 days ahead and refrigerate. Reheat gently in a skillet over medium heat before spooning into freshly roasted squash halves.
Yes. Roast the squash halves until tender (usually 35–45 minutes at 400°F), then scoop out the strands before filling with the warm sausage mixture.
Absolutely. Hot sausage will add more heat; balance it by reducing or omitting the red pepper flakes.
Yes. Spaghetti squash is low-carb, and the sauce relies on cream cheese, sausage, and broth with no added sugar. Check your sausage brand for carb content.
Freeze the sausage filling (not the roasted squash) in an airtight container for up to 3 months. Thaw and reheat before serving over freshly roasted squash.
