Stupid Easy Paleo Spaghetti Squash & Meatballs


One of my most popular recipes, where I discovered that you can fully cook a spaghetti squash in your crock pot! If you haven’t tried it yet, I highly suggest you do so!




I had been playing with the idea of doing a spaghetti squash and meatballs dish in the slow cooker (at the same time) for a while now. I decided to take a stab at it making it as easy as humanly possible. The verdict is that it worked out perfectly and will now be a lazy go-to meal for me. The squash cooked perfectly and scooped out easily as well. Exciting stuff.


I only used a few non-pantry items. Easy right?

What you need:

  • One medium spaghetti squash.
  • One pound of ground Italian sausage.
  • One can of tomato sauce, I used a 14 ounce can.
  • 2 tbsp of hot pepper relish (optional).
  • 4 to 6 cloves of garlic, whole.
  • 2 tbsp of olive oil.
  • Italian seasoning (Oregano, Basil, Thyme) to taste, I used about 2 tsp

Equipment Needed:


What it looks like going in…


How you make it:

  1. Make sure you use a large 6 quart slow cooker or Instant Pot for this recipe. 
  2. Dump your tomato sauce, olive oil, garlic, hot pepper relish and Italian seasoning into your slow cooker and stir well.
  3. Cut your squash in half and scoop out the seeds.
  4. Place your 2 squash halves face down into your slow cooker.
  5. Roll your ground sausage into meatballs, then fit as many as you can in the sauce around the squash. I was able to work in about a half pound worth.
  6. Cook on High for 3 hours or cook on low for 5 hours.
  7. Use a large fork to pull the “spaghetti” out of your squash, then top with your meatballs and sauce.
  8. Garnish with parsley if you feel fancy, and enjoy!


The finished product.
The finished product.




Stupid Easy Paleo Spaghetti Squash & Meatballs

Comments 81

      1. Please don’t use the microwave if you are trying to eat healthy! It creates toxins in the food! Germany has banned microwaves in homes!

          1. It seems Kathy’s response was meant for Emily’s comment about using the microwave to soften the squash for cutting.

  1. I just bought a spaghetti squash for the very first time ever and yours is the first recipe I intend to try for it! 🙂

  2. Can you do half of this recipe in a smaller crockpot? I only have a 3-quart crockpot (I live alone and mostly cook for myself, so I don’t need a huge one!), so do you think it would work to just half the whole recipe?

  3. What a great meal! I’ve roasted spaghetti squash and made meatballs in tomato sauce on the stovetop, but never in the crock pot. This came out great! I can never get spaghetti squash cooked just right in the oven, it’s either too hard or too squishy. I was worried that it might be mushy in the crock pot, but it came out perfectly! My only complaint was that the sauce was runny…but that was my fault since I added an extra can of tomato sauce to be able to cover the full pound of meatballs. Next time I might throw a splash of red wine to the sauce!

  4. This rocked! Two of my three boys loved it, and the other one loved the sauce and meatballs. I added some ground beef (85% lean) to the sausage to make it go farther. We will keep this one around! Oh, I forgot, its a good idea to scoop out the squash and let it drain a little more before serving it. EXCELLENT!

  5. OMG! This is so good! I didn’t have the pepper relish so I put in chili pepper seeds and from the way my mouth is burning… I put in too much! LMAO… I was able to shove the whole pound of sausage in my pot and because we stepped out of the house I think I may have slow cooked this on low for at least 8 hours. Still fantastic and the squash wasn’t yucky cruncy! Thanks so much for a fab reipe!

    1. You don’t need the red pepper relish, yet most any large supermarket will have it, usually in the international asile with other Italian goods.

  6. Hi. I’ve only just found this site through my g/fs pinterest…. am I missing something here? How is spaghetti allowed on the Paleo diet? Or (from loads of recipes) rice?

    1. It’s not literally spaghetti, just spaghetti squash. Also I do not include rice in my recipes, yet I do use cauliflower as a substitute. Hope this helps…

  7. OMG! This was amazing. Even my 5 year old devoured it and asked for seconds. This has defintiely earned a permanent spot in our dinner rotation. Thanks!

  8. I adore my Crockpots i own three.
    I will have to try this.. i may even try taking the ‘rind’ off the Spaghetti Squash, like you would with a butternut…

  9. Just finished loading the crock pot, can’t wait to eat this. I cheated and used a premade all natural spaghetti sauce because I didn’t have tomato sauce on hand.

    This is my first spaghetti squash and my first crock pot meal. My wife usually does the slow cooking 🙂

  10. Good Stuff!
    First experience with spaghetti squash and I must say this tastes better to me than regular pasta ever has.
    Great recipie

  11. I crammed TWO spaghetti squashes in my 6qt crockpot… hoping this is a hit with my 4 kids tonight! 🙂 Love your site and am excited about trying a few more things.

  12. This looks delicious! Will it come out ok if I leave on love for 8-9 hours instead of 5? I work all day and usually cook
    In the pot all day until I get home (don’t have a programmable crock pot)

  13. Put this together the other night and left for hubby to throw on low. Let me just easy…. EASY and YUM! It was delicious.

  14. I made this tonight with ground buffalo instead of sausage, and it was really good! This is the first Paleo meal I’ve ever made (intentionally, at least), since I’ve been considering whether to try out this lifestyle, and this recipe is definitely swaying me towards yes!

  15. Trying to make this with ground turkey, but the meat balls seem to be too squishy to hold shape. Was trying to avoid using rice in them for shape. Any advice? I’m starting to think even if the meatballs don’t hold shape, it can just be a meat sauce, right?

    1. I put the meatballs in a skillet briefly just to brown it a little. After a minute or two, I threw them in the crockpot and they came out really good! Not squishy at all.

  16. Thank you for this recipe! I didn’t have the relish so added red wine – perfect! Always wanted to cook up a squash, but without the oven (in AZ, no oven in summer). This was perfect. we’ll be having this as a regular meal.

  17. I bought spaghetti squash especially for this recipe and I’m so excited to try it. It really simplifies squash cooking.

  18. I love this recipe because I can get it going and not have to worry about it and dinner is all set after a busy day of being mom/taxi driver to my 4 kids!

  19. Love this recipe although I changed it a tad to be AIP compliant. I also used ground chicken and a more garlicky creamy sauce with coconut milk to sub for tomato sauce to make it nightshade free!

  20. Made this today. Extremely easy and it came out great. Thank you for sharing this recipe I would have never have thought to make spaghetti squash in the crock pot.

  21. I came across this recipe of yours today by spotting the photograph posted somewhere. We have had spaghetti squash and meatballs previously, but I never made it in the slow cooker.

    Your recipe makes this way too easy. 🙂 Next time I will make my own sauce and jazz it up a bit, but my goodness, this was as simple as could be. Three hours on high was just right.

    Thank you for sharing this.

  22. Great recipe and easy! My spaghetti squash was huge, so I used my dutch oven instead of the crock pot and it turned out great. To make it even easier, I bought premade meatballs from the meat counter at Whole Foods. Perfect!

  23. Is it important to wash the squash really well since it’s cooking in the sauce? I’m not sure how much I should be scrubbing it…


  24. I have a 5 quart round slow cooker so I was wondering if I could cut the squash up into quarters so that it fits better? Does that change the cooking any? This sounds like a wonderful recipe – easy, quick, all in one pot, cooks while you do something else.


  25. This looks great. I can’t wait to try. One question I have is how do I pull the spaghetti out of the squash with a fork. Any help describing that process would be great.

  26. Just made this. Made meatballs out of ground beef I had (added some herbs, spices and an egg). I didn’t have the red pepper relish, but had something similar so used that. And I had left over tomato sauce from another meal. My first time making spaghetti squash!
    It was really unique — had to get used to it a bit. But after a few bites we did and found the whole thing quite yummy and delish. Thanks!

  27. Okay, so I LOVE spaghetti squash and this sounds like an awesome dish, especially since it is done in the crock pot; however how is this paleo? Canned tomato sauce and the jarred relish are not considered paleo, as it has tons of refined salts, its processed and it has other ingredients that are not natural.

    1. I respect your opinion to form your own evaluation of what is considered strict paleo or not. In your instance, you can simply replace the canned tomato sauce with fresh pureed tomatoes, and then pickle and dice your own hot relish, and perhaps even make your own farm fresh sausage.

      The main concept here is that the squash will work in the crock pot, I hope you try it with your own ingredients and let me know how it comes out!

  28. I take it you can substitute any kind of meat for this. Wonder if anyone has tried different meats like a mixture of ground beef and turkey, etc?

  29. I didn’t use the relish but I couldn’t imagine it making this dish any better. Holy yum!! This was absolutely delicious. Thank you for sharing! I have a 2 year old, five year old and noodle loving husband AND this was a hit. Win!

  30. I made this tonight with great results! I used turkey sausage (in thick slices) instead of making meatballs, and they came out tender and yummy. Thanks for sharing!

  31. Complimenti!!! This was the best version of spaghetti squash and meatballs I’ve ever tried — and the easiest!!! I love the sauce, and intend to reuse it whenever I need an awesome marinara-type sauce.

    I have to admit I was skeptical about the hot pepper relish, and had to scrutinize the italian section of my grocery store to find it, but it was THE BOMB! I love this soooo much! Thank you!!!

    I tried to dip all of my meatballs in the sauce and put them wherever (even if there wasn’t enough sauce to cover them while cooking). Totally worked!

  32. AMAZING! I loaded the crockpot this morning. Eating a delicious, late lunch. I used grass fed beef (1 lb) and about 1/4 lb sausage. I will definitely make this on a regular basis. SO VERY EASY AND DELICIOUS!

  33. I am trying this tonight with chicken meatballs!! (ground beef and I dont get along). Thank you this looks awesome!

  34. Just made this for my pre-triathlon race meal and LOVED it! So did my dad, mom, and grandma! I’ve made spaghetti squash a lot of ways, but this for sure was the best! Also, I added a ton of veggies in to the “sauce” and it turned out delicious! THANK YOU!

  35. I like how this cooks the squash way better than the oven, makes it really soft and not crunchy. Had this for dinner, it was good! So easy, turned on the crock pot to low and it was ready when I got home from work 7 hours later-actually it was boiling and probably done 2 hours earlier but that’s ok!

  36. This recipe is so delicious! I usually cook spaghetti squash in the oven so I was a little sceptical, but it came out great! It was so good I ate it five says in a row and was still craving it a few days later and made another batch! The first time I made it with a mixture of ground beef and Isernio’s Breakfast Chicken Sausage. The second time I just used two packages of Isernio’s Italian Chicken Sausage. I liked the first batch a little better. I’m sending this link to everyone I know! Thanks for this! Five stars!

  37. I’ve never had spaghetti squash before. my boyfriend and I are trying to go paleo and this was our first meal. he just told me it was the best meal I ever good cooked him.

  38. OMG This was soooo good and easy. I made it with Italian spiced sausage, homemade marinara and spaghetti squash. My 10 year old liked it. Thanks for the idea!

  39. This dish is absolutely amazing! We had never tried spaghetti squash before and were a little scared, but it turned out amazing! We previously had tried shirataki noodles for low-carb dishes and hated the soft, mushy texture of the noodle, not to mention the seaweed smell. For anyone on the fence about spaghetti squash, try this dish. The squash still has a bite and chew to it, much like real pasta. It’s also filling and will keep you full for hours like a real pasta would.

    Thanks so much for this recipe! We especially like it when we need a hearty meal but it’s too hot to use the oven. This will be in heavy rotation in the summer.

  40. Meatballs- I’m new to paleo; I usually use egg and bread crumbs and parm cheese in mine; obv I’m changing over so – can I keep the seasoning and onion ? Then just the meats I choose ? None of the other ingredients I use to use are allowed anymore ?

    Gonna try this, this week for sure! We use to eat spaghetti and meatballs once every other week!

  41. I made this tonight. It was really good!! Even my picky eaters ate it!
    I made extra meatballs with the left over sausage and baked them in the oven.

  42. Just made this and it was really good. My squash was a bit watery- I’m guessing I over cooked in the crock pot? I used crushed tomatoes ( trying to keep it to real food vs any processed) added seasonings including a bay leaf and it was very good. Can you let me know about the watery squash? Thanks great recipe!

  43. This recipe is fabulous! I made it with San Marzano tomatoes and once can of organic paste. I used grass-fed beef and Paleo bread that I made into bread crumbs. This is the best way to cook spaghetti squash I’ve ever tried. It’s tender and perfectly cooked. I make this in the crockpot, add the sauce, then squash and put the raw meatballs around (some submerged, others not) after a few hours I stir the out-ofsauce meatballs in to the sauce. Perfect!! Thank you

  44. My family loves this recipe so much, we make this 2-3 times a month! I add a pound of ground beef or turkey to stretch this into mutiple dinners or lunches. Thanks for the great recipe!

Leave a Reply

Your email address will not be published. Required fields are marked *

log in

reset password

Back to
log in