Paleo Sausage Stuffed Peppers


Sausage and In Peppers

Sausage and peppers has always been one of my favorite Italian comfort foods, and also rather easy to make. I had been pondering writing some new stuffed pepper recipes due to their easy, and decided to spin the common recipe to merge my love for two different recipes. This is another one that is an easy way to feed the whole family with 10 minutes of prep time, or simply get 3 or 4 meals cooked ahead of time for yourself.


This is a picture before cooking in the crock.

What you need:

  • 1 pound of ground Italian hot sausage.
  • 5 assorted bell peppers. I went with 2 green, 2 red, 1 yellow.
  • 1/2 head of cauliflower, grated or chopped into a “rice” consistency.
  • 1 small (8 ounce) can of tomato paste.
  • 1 small white onion, medium dice.
  • 1/2 head of garlic, minced.
  • 1 small handfull of fresh basil, minced (or 2 tsp. dried).
  • 2 tsp dried oregano.
  • 2 tsp dried thyme.

Equipment Needed:

6-Quart Crock Pot or Instant Pot set on Slow Cook / Regular with the Instant Pot tempered glass lid.


How you make it:

  1. Cut the tops off of your peppers and scoop out and discard the seed, yet do save the tops!
  2. Process or chop about half a head of cauliflower into “rice” and put in a large mixing bowl.
  3. Add your minced garlic, basil, and dried herbs, and onion to your cauliflower and mix by hand.
  4. Use a very hot skillet to lightly brown your sausage. This step is entirely optional based on your motivational level. The sausage will cook just fine in your slow cooker, yet I personally like to hit it with a little sear to take the flavor up a notch.
  5. Add your sausage and can of tomato paste to your bowl of seasoned cauliflower and mix by hand. Let the kids do this part, getting hands messy in necessary, a spoon just won’t cut it.
  6. Fit as much of your sausage mixture into your peppers as you can. Place your peppers into your slow cooker and loosely place the pepper tops back on. If you have extra meat and cauliflower mixture, just jam in between your peppers and let it cook. You could save it for a breakfast scramble too if you are awesome, yet I’d just feed the slow cooker more.
  7. Cook on low for 6 hours. I set my slow cooker to shut off once it’s temperature probe hit 180 degrees. Maybe I just like using that feature. Just cook it on low for 6 hours.
  8. Please do post in comments if you made any super modifications to this recipe you think others will enjoy.




  1. Analisa says:

    Where do you buy paleo approved sausage?

    1. Greenz says:

      I could not find paleo sausage, so I went with some ground beef, salami, and turkey bacon. I just wing’ed it on the portions. I also added Green onions to the mixture. I didn’t have cauliflower so I used broccoli. I only used green peppers, so its super green. I call it Greenz Stuffed Peppers. Will try it out in a few hours and let everyone know. Wish me luck!

      1. Jason says:

        Nice! What kind of sausage is acceptable to you is a personal choice. The biggest difference here is your use of broccoli instead of cauliflower, which usually is used to take the place of rice. That still sounds like something I would totally eat. If it comes out good, take a picture and share it up on our facebook page please! Good luck!

    2. Mindi says:

      Aidelle’s sausage is paleo/whole 30 approved. Wal Mart or local grocery chains usually have it.

  2. Heather says:

    Loved this! My 9 year old son loved it too. He didnt even know that it wasnt made with rice.

  3. Lily says:

    Having grown up eating stuffed peppers (a staple of the Eastern European diet), i tried making the paleo version. As i couldnt find Italian sausages anywhere, i used ground beef instead. Similarly, as i had no dried oregano in the cupboard, i substituted dried mixed herbs instead. I had quite a bit of mixture, so much so that ive ended up with about a week’s worth of food! (10 capsicums used lol) Which is GREAT, given i have 11 month old twins to care for – so now i dont have to cook for a while :o) I didn’t have a slow cooker either, so i just placed the capsicums in two pots, and cooked in the oven at 180 degrees celcius for 1 1 /2 hrs. I also added lots of black and cracked pepper and some salt to taste. It tastes amazing!

  4. Layla says:

    Here’s a link to a Homemade Italian Sausage recipe (hot or mild, to taste). I’ve made it with some minor modifications to paleo-ify… I’ve used this mixture to make patties or in hashes, paleo pizza, frittatas. I don’t put in the sugar and it is still fantastic. I intend to try the above recipe with this:

  5. Sarah says:

    Thank you so much for this recipe. I made it today with turkey sausage. It was delicious. I’ll be eating this for lunch the next couple days.

  6. Julia says:

    Stuffed peppers are my hubby’s favorite meal. I usually only make them for his birthday, but these looked so yummy that i decided not to make him wait. I doubled the recipe (there are six of us) and made them with 1/2 grass fed beef and 1/2 Italian sausage. I still kept the spices in the same quantity and definitely used the cauliflower in place of the rice. I also added a smidge of salt. I cooked all of the meat before I put everything in the crockpot and they were done in about two hours on low. Lastly, I added about 1/4 cup of water to the bottom of the crockpot– just enough to steam the peppers nicely (normally, I would have put them in a pot of boiling water to soften them up a bit before stuffing them). These were delicious! Thank you so much. I can’t wait to try more recipes from your site (tomorrow is the apple, bacon, pecan stuffed pork chops. Yum!).

  7. Lucky says:

    6 hours in a slow cooker on low is way too long. Peppers will turn to mush and make it hard to serve. They will still taste good, but have the consistency of that Halloween pumpkin on your porch that you forgot to throw out.

    1. Muttlover says:

      Love your description of the state of mushiness. Was very easy to picture.

  8. JoanieGirl says:

    I just put mine into the crock pot. I made it exactly as the recipe states. I don’t know how you had any extra filling though. I used 5 peppers; 2 green, 2 yellow, and one red and had to skimp on filling the last pepper. They were probably larger than the peppers you used, I guess. I may try using extra meat next time or maybe half sausage and half burger or maybe even a mix of hot and sweet sausage. Oh well, I’m looking forward to eating these later! They smell yummy!

  9. Kelly says:

    I made these last night and I was impressed. I’m not huge on sausage flavor, so next time I make them I will probably use hamburger – or half and half. Anyhow, loved them. My 4 year old even ate them. 🙂

  10. Brian says:

    I’ve made this several times, my whole family enjoys it. I usually like to stuff extra sausage links in for my son. This time, with the left over mixture, I chopped up the other half of cauliflower and added a can of diced tomatoes. This way, I won’t have a half of head of cauliflower left and it make a nice sauce to spread over the peppers. Btw, I used roughly 1-1/2 lbs of sausage and only 4 peppers that way I had a lot of extra “stuffing” for the pot.

  11. I just made these tonight. Instead of the Crock Pot, I baked them in the oven at 375 degrees for 30 minutes. I made my filling in a large pan on the stove. Sugar-free Italian sausage, onion, garlic, above spices, sea salt, pepper, 14 oz. can tomato sauce and one head cauliflower processed into “rice”. Once everything was cooked/heated through, I stuffed 6 bell peppers. Worked perfectly!

  12. Jenn says:

    Just popped into the crockpot, and can’t wait to eat. I have never made stuffed peppers, but my husband grew up eating them so I can’t wait to see what he thinks.

    I, of course, couldn’t find an 8 oz can of tomato paste, so I used 1-6 oz cans of organic paste. I figure this will make it more juicy (and was too asleep to weigh it out this am. I think I need to add more cauliflower. I used about 3/4 medium head, but as I had very large peppers I could have used more filling as well. I believe I will also try getting some ground venison and/or buffalo to use for this. Okay, not I am seriously hungry for this.

  13. Priscilla D. says:

    This recipe looks so good; I really want to try it! Is there anything else I can substitute the peppers for, since my husband doesn’t like bell peppers? He is the pickiest eater, lol.

    1. Alexandra says:

      My Greek grandmother uses tomatoes instead of pepper….so yum!

      1. Pia says:

        Oh! I wish I’d see this before!!! As peppers are not in season now, they are really not good, tomatoes would such a better choice.

    2. T.M. says:

      Try Italian peppers,longer and thinner than bell peppers,better tasting too

  14. Mary says:

    Stuffed peppers are a weekly staple around here! Only, we never brown the meat…when we do we find them overdone 🙁 We use them as a vehicle to use up veggies that may be on their last legs (or roots)… Brussels sprouts, tomatoes, broccoli, left over sweet potato…whatever we need to use we just chop up small and mix it in! I have never found a paleo-friendly sausage in the stores, so we mix ourmeats. Ground buffalo is nice mixed with pork, turkey, etc etc! Thank you for posting!

  15. Dana says:

    Curious if others have tried this would searing the meat as I wonder if the uncooked sausage in the crockpot would make the dish greasy?

  16. Sharon U says:

    I just got our newest CSA package of meat today, so I did not have the time to use the crock pot. But, I wanted stuffed peppers after seeing this post. So, I made some changes so I could bake them in the oven. I did keep the pepper tops, but just diced them and put them in the mix with the onions and garlic. Instead of mixing everything by hand, I mixed it all and heated it through in the same pan as I browned the meat. I also used ground beef instead of sausage. I added a finely chopped stalk of bok choy to the mix as well since I add that to almost everything anyhow for extra nutritional pow. I also added a 4oz can of tomato sauce since I was not cooking in the crock and it needed more moisture.

    I baked for 25 minutes at 350*. The tops came out crunchy and the whole dish was super yummy!

  17. Wyn-Erin says:

    Made these today. Yum! I only used four peppers so there was more extra stuffing than the recipe intended. Made it a little soupy but it was still delicious. I used Italian brats from our farmers co-op (took them out of casing).

  18. anthony says:

    Hey, I made this with some small changes, ground turkey, chipotle pepers, jalapeno, some cayenne, and a tiny bit of chopped tomatoes. I did however use a whole head of cauliflower and 12oz of paste. Mine tastes great but is MUSH! The bell peppers are water logged and kinda nasty. ADVICE??? PLEASE.

  19. Hildegarde says:

    Hey! I’m at work surfing around your blog from my new iphone!
    Just wanted to say I love reading your blog and look forward to all your posts!
    Carry on the excellent work!

  20. Sam says:

    I actually cooked my sausage throughout before adding it to the mix, because I didn’t want the mixture to taste too greasy. Then I roasted the peppers in the oven for almost two hours, but the stuffing never got soft and was pretty dry: cauliflower and brocolli still crunchy! I’m going to try these again tonight, and I won’t brown the sausage as much. I’ll cut tiny openings in the bottom ends of the peppers so that the grease can leak out if it wants, and see how that works.

    Loved this recipe idea! I can’t wait to take them for lunch.

    1. Alexandra says:

      Hi Sam,
      I really wouldn’t worry too much about the “grease”, or if you do, try going with straight ground meat.

  21. Kristen says:

    I want to make these in the oven-how would I do that or what would I need to change? Should I cook the meat thoroughly?

    1. Jason says:

      You can bake them, yet you do want to make sure they get to temperature. I would try something around 350°F for 30 to 40 minutes for starters. Perhaps google some baked stuffed pepper recipes and compare. That’s why the ease of the slow cooker for this recipe is great.

  22. Megan says:

    I LOVE this recipe! I just made it for the second time I’ve made them, and both times I taste it I can’t believe that I made it from scratch. Awesome!!!

  23. Peggy says:

    Made these tonight and they turned out delicious! You couldn’t even tell there was cauliflower in them instead of rice. One was very filling and more than enough. Peppers were slightly on the soft side, so I may cook on low for 5-5 1/2 hrs. next time and see how they turn out. I love the idea of slicing off the top and putting it back on, gave it a very cute appearance. Thanks for sharing your recipe!

  24. lisa says:

    One of my go-to recipes. here’ how I modify:
    1) 6 hrs on low is too long. 2-3hrs
    2) organic ground turkey for less calories. I heat fennel seed and crushed red pepper in dry skillet before browning turkey. Same flavor as Italian sausage but far less fat.
    3) add 1 bunch spinach
    4) add 1 carton of mushrooms

  25. Remy says:

    This is a great Paleo take on Turkish Dolma! Awesome find!

  26. Mandasuehill says:

    I used leftover shredded chicken since no paleo friendly sausage found. Yum!!! Thanks for the awesome idea!!!

  27. Andrew says:

    I cooked this the first time following the recipe exactly and it was really good! Yesterday, I substituted shredded butternut squash. That worked really well also. The flavor of the squash and the sausage make a good match, and seemed to give the mixture a little more texture.

    Ditto on the above comments about the peppers turning to mush. Next time I will start checking with a thermometer about 3 hours in. I would much rather have an over cooked pepper than under cooked sausage!

  28. Richard says:

    Just tried it, loved by all 3 of us! I tripled the meat/ingredients used 11 peppers but no real leftover meat/mixture. Awesome!!!

  29. Katie says:

    Excellent!! We used lamb instead of sausage but love it!

  30. Ashley says:

    Dear mg about the peppers not surviving the vast amount of time in the slow cooker, when I make this recipe I might blanch them for 5minutes, just to keep them crispier for longer? 🙂

  31. Jess says:

    My slow cooker doesn’t have an option to shut off automatically. Once I leave for work, I’m gone for ten hours minimum. Is it okay to cook on low for that whole time or should I just wait to make it until I have a day off?

  32. Aimee Maria says:

    Has anyone cooked, then frozen then, and re-heated? And recommendations for re-heating? Oven?

  33. Jenna A. says:

    Does anyone happen to know the prep time? Im looking for relatively quick meals.

  34. Sue says:

    I followed the recipe as written but made a little extra stuffing to put in and around the peppers. I added a can of organic fire roasted tomatoes to the loose mixture to later serve with spiral zucchini.

  35. Allison says:

    Can you cook this on high for 3 hours?

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