Keto Manicotti with Beef and Sausage

Keto Manicotti with Beef and Sausage is an Italian-American classic. It is perfect for “Pasta Night.” And, yes, you can stay low carb and enjoy a hearty and delicious pasta. We use our low-carb Keto Almond Flour Tortillas for the shells and stuff them with a tasty blend of beef and Italian sausage. Topping with creamy marinara sauce and lots of melted Mozzarella will make this classic one you will enjoy often.

Let’s first clear up a misconception. Is it Manicotti or Cannelloni? It may not matter and may just cause a debate among our followers, but we think the difference is simple. Manicotti is a stuffed crepe-like shell that you fold together around your filling and Cannelloni is a stuffed pre-made hard wheat-based pasta shell. Both are baked, covered with marinara and cheese, and both are delicious!


For this recipe, we used a simple homemade marinara sauce. On the other hand, you can use your favorite marinara recipe if you have one you like. We would also suggest giving our Tomato Basil Marinara Sauce a try – it is a perfect choice! If you want to shorten the time-frame and hit the dinner table quickly, try using a low-carb jarred Marinara sauce. For this choice, we only recommend Rao’s Homemade Marinara Sauce. Eight ounces of Rao’s has only 4g of carbs.

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Our quick Marinara is made with canned Cento crushed tomatoes, onion and garlic, and spiced with dried oregano and freshly chopped basil. It only takes 20 minutes from start to finish and while it is cooking on the stove-top you can be preparing the cooked meat sauce.

Classic stuffings for Manicotti contain lasagna-like ingredients. Ground beef, ricotta cheese, marinara sauce, lots of mozzarella, and Italian spices. Our recipe is no different. On the other hand, we do have a Tasty Low Carb twist on the classic. We like to add some ground Italian hot sausage to the meat sauce! Pick your favorite and you will be amazed at how much it adds to the flavor. Certainly, you can use sweet Italian sausage instead or even leave it out for a more traditional Manicotti.

Preparation Tips

We always have a supply of our Almond Flour Tortillas in the freezer – they make a perfect shell for Manicotti. If you have not tried this recipe stop here and make a batch. They are so handy to have on hand for any Mexican shell recipe, tacos, and even for making low-carb tortilla chips for dipping. They are similar to the Keto Lasagna Noodles we make for that classic dish.

Our filling is made in a large skillet. One tip we have is to use a bit of the fat from cooking the meats to cook the onion and garlic for the recipe. It adds a lot of flavor. We also use fresh basil and usually have some on hand. Joanie actually has a green thumb. She grows all we can use on a kitchen window shelf. There is something about the taste of fresh basil that changes the whole flavor of a dish. This recipe even calls for using fresh basil as a garnish.

Egg yolks hold the mixture together and makes the ricotta in the filling even more creamy. As a twist, you may also want to include some wilted spinach in the mix. If you do, we strongly suggest using fresh spinach that is wilted in the skillet. Frozen spinach will not be good in this recipe. In fact, we never use frozen spinach. Fresh is best.

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Manicotti with Beef and Sausage – Ready for Pasta Night!

Keto Manicotti with Beef and Sausage means you are ready for “Pasta Night!” If you do not have a “Pasta Night,” then you should start one! The taste of our stuffed Manicotti will help make that a special night with a low-carb delight! Your whole family will enjoy this recipe – let us know what you think!

Keto Manicotti with Beef and Sausage

4.8 from 21 votes
Recipe by Joanie and Chris Course: PastaCuisine: ItalianDifficulty: Easy


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Keto Manicotti with Beef and Sausage is perfect for “Pasta Night!” Yes, you can stay low carb and enjoy pasta – this one is hearty and delicious!

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  • Marinara Sauce
  • 2 tablespoons 2 tablespoons Olive oil extra virgin

  • 1/2 cup 80 g Onions diced

  • 3 cloves 3 cloves Garlic chopped

  • 28 ounce 28 ounce Tomatoes crushed, Cento

  • 1/4 cup 59 g Basil fresh, chopped

  • 1/2 teaspoon 1/2 teaspoon Oregano dried

  • 2 teaspoons 2 teaspoons Erythritol

  • Sea salt to taste

  • Pepper to taste

  • Manicotti
  • 1 pound 454 g Ground beef extra lean

  • 1/2 pound 227 g Italian sausage hot

  • 1/2 cup 80 g Onion diced

  • 1/2 cup 80 g Bell pepper diced

  • 4 cloves 4 cloves Garlic chopped

  • 1/3 cup 78 g Basil fresh, chopped

  • 1/2 teaspoon 1/2 teaspoon Oregano dried

  • 1/4 teaspoon 1/4 teaspoon Sea salt

  • 1/8 teaspoon 1/8 teaspoon Pepper

  • 1 1/2 cups 168 g Mozzarella cheese shredded

  • 1/2 cup 123 g Ricotta cheese

  • 2 tablespoons 2 tablespoons Parmesan cheese grated

  • 2 2 Egg yolks

  • 12 12 Almond tortillas Tasty Low Carb

  • 1/4 cup 6 g Basil, chopped


  • Marinara Sauce
  • Heat a large skillet to medium heat. Add the olive oil and chopped onions and cook for 4 minutes until slightly translucent.
  • Add the chopped garlic and cook for 1 minute until fragrant.
  • Pour in the crushed tomatoes and cook for 5 minutes. Then add the basil and oregano. Stir to combine and cook for an additional 5 minutes.
  • Add the erythritol and salt and pepper to taste and let simmer for 5 additional minutes.
  • Manicotti
  • In a large skillet, cook and break up the beef and sausage over medium heat until browned (about 10 minutes). Remove with a slotted spoon and set aside. Drain all but 2 tablespoons of the fat drippings from the skillet.
  • Add the onion and bell pepper and cook for 4 minutes until translucent. Add the garlic and cook for 1 minute until fragrant.
  • Return the beef and sausage mixture to the skillet and add 1/2 cup of marinara, oregano, salt, pepper, and basil. Cook together for 5 minutes. Remove from the heat.
  • Stir in 1/2 cup of mozzarella, the ricotta, parmesan, and egg yolks. Mix well. Fill a tortilla with the mixture and fold to form a roll. Place the tortillas in a baking dish and bake at 350 degrees for 10 minutes (covered).
  • Remove the cover and sprinkle with remaining mozzarella on top of a spoonful of marinara. Bake uncovered for an additional 10 minutes or until bubbly.
  • Serve with a garnish of chopped basil and sprinkled parmesan.


Chef’s Notes

  • The marinara sauce is a simple recipe and tastes great. If you prefer you can use Rao jarred marinara sauce. It is low carb and delicious. One final tip – you can use a toothpick to secure the top of each shell after filling. Make sure you remove them after baking.

Nutrition Facts

  • Serving Size: 2g
  • Calories: 554.3kcal
  • Carbohydrates: 11.7g
  • Protein: 30.4g
  • Fat: 43g
  • Saturated Fat: 17g
  • Trans Fat: 0g
  • Cholesterol: 180.9mg
  • Sodium: 655.3mg
  • Potassium: 758mg
  • Fiber: 2.6g
  • Sugar: 5.6g
  • Vitamin A: 1660IU
  • Vitamin C: 22.5mg
  • Calcium: 269.8mg
  • Iron: 2.9mg

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    • Joanie and Chris

      Thank you so much for letting us know. We have had other posts stolen, it is very upsetting. Especially since we work so hard to create recipes in our kitchen and also the hours spent photographing and composing our blog write-ups. We will contact the thief if possible and certainly report to Google. Your comment is much appreciated . . . Joanie.

  1. Hi, it seems a large part of the instructions for this recipe are missing. It jumps directly from cooking the mixture, to the last 10 minutes of baking. Help!

    • Joanie and Chris

      Sorry, our post writeup talks about using our Tasty Low Carb tortillas. The mixture is stuffed in them before baking. I will fix, to be clearer. Thanks for helping . . . Joanie.

  2. Pingback: Keto Manicotti with Beef and Sausage — Tasty Low Carb | My Meals are on Wheels

    • Joan and Chris

      We are pleased that “My Meals Are On Wheels” is a fan of our Keto Manicotti with Beef and Sausage. Thanks so much. Click their link above to check out their site.

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