Pesto Spaghetti Squash with Turkey Sausage

Pesto Spaghetti Squash with Turkey Sausage is a low carb dish that's filling and packed with flavor from a homemade basil pesto and lean turkey sausage. Topped with melted cheese, this dish is one you will make again and again.

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This healthy Pesto Spaghetti Squash makes an easy dinner that's is packed with protein, veggies, and quick homemade basil pesto. It's good for you, low carb, and can be easily adapted for Whole30 and Paleo diets.

Sometimes the very best recipes are ones that happen completely by accident and necessity. This is one of those recipes. Originally I was planning on making a creamy basil spaghetti squash dish, which I probably will still make eventually, but I realized I had completely forgotten the cream element of the sauce. Staring at the ingredients and determined to make something for dinner, I immediately thought of pesto.

Not only is pesto the perfect vehicle for all the basil, but it's also something I absolutely love with spaghetti squash. It mimics some of my favorite pasta dishes and the pesto and slightly sweet spaghetti squash are made for each other. 

Then to pack in even more flavor into this pesto spaghetti squash, I added some browned lean turkey sausage. The seasoning of the sausage kicks up the flavor of the whole dish and adds protein to make it a more complete meal. You could use almost any protein you like - chicken, shrimp, ground turkey, tofu, or even white beans would work.

Pesto Spaghetti Squash in a hollow squash with tomatoes and basil.

How to Cook Spaghetti Squash

There are lots of different ways you can cook spaghetti squash for this recipe. The easiest is to steam it in the microwave. Start by poking holes into the squash using a fork or sharp knife. Then place it on a microwave safe dish and microwave for 12-15 minutes until it is soft to the touch and you can press into the skin with your finger. Remove from the microwave and carefully cut in half. Remove the sands and use a fork to separate into strands.

To roast the spaghetti squash, preheat the oven to 400 degrees. Cut the spaghetti squash in half using a sharp knife. Remove the seeds using a spoon. Drizzle with olive oil and season with salt and pepper. Place cut side down on a baking sheet and roast for 40-50 minutes until tender. Use a fork to remove the squash into strands.

How to Make Homemade Pesto

To keep things light, this recipe uses a skinny pesto that uses less than half the amount of oil normally called for in a pesto recipe. However, you can defintiely swap in a store-bought pesto if you don't want to take the time to make your own. Here's the basic recipe for pesto:

  • 2 cups basil leaves, packed
  • 6 tbsp. water (or olive oil)
  • 4 tbsp. Parmesan cheese, grated
  • 1/4 cup pine nuts (or other nut)
  • 1 tbsp. olive oil
  • 3 cloves garlic
  • 2 tbsp. lemon juice
  • 1/4 tsp. salt
  • 1/4 tsp. black pepper
  • Directions: Add all the ingredients to a high powered blender or food processor and blend/pulse until combined.

Low carb Pesto Spaghetti Squash on a marble background with tomato slices.

Tips for Making this Pesto Spaghetti Squash

  • Pesto can be made all kinds of different ways. Traditionally it uses basil and pine nuts, but you can try different greens and nuts. I love making it with spinach, cilantro, kale, or parsley. You can use walnuts, almonds, and even cashews. For a more traditional style, add some extra olive oil and for a creamy version add some cream cheese or half and half.
  • Spaghetti squash can be roasted in the oven or quickly cooked in the microwave. Roasting it will add a touch more flavor but with such a flavorful sauce, you can't really taste the difference in this recipe.
  • For a Whole30 or Paleo version, leave out the Parmesan and mozzarella cheese. Use a touch more olive oil in the pesto and add some extra salt if needed.
  • For some extra veggies, toss in some fresh or cooked cherry tomatoes. You can also use canned diced tomatoes.

Looking for more spaghetti squash recipes?

The Recipe
Pesto spaghetti squash with melted cheese, turkey sausage, and diced tomatoes.

Pesto Spaghetti Squash with Turkey Sausage

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  • 1 cup basil leaves, packed
  • 3 tbsp. water
  • 2 tbsp. Parmesan cheese, grated
  • 1/8 cup pine nuts (or walnuts)
  • 1/2 tbsp. olive oil
  • 1 clove garlic
  • 1 tbsp. lemon juice
  • 1/8 tsp. salt
  • 1/8 tsp. black pepper
  • 2 spaghetti squash
  • 1 lb. lean ground turkey sausage
  • 1/2 cup shredded part skim mozzarella

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Using a food processor, pulse together the first nine ingredients for the pesto.


Cook the spaghetti squash: Preheat the oven to 400 degrees. Cut the spaghetti squash in half and remove seeds. Spray with cooking spray and sprinkle with salt and pepper. Place cut side down on a baking sheet and bake for 35-40 minutes until tender. You can also microwave the spaghetti squash. Pierce it all over with a fork or sharp knife. Microwave for 10-15 minutes until tender to the touch. Carefully cut in half and scoop out the seeds. Then use a fork to scrape out the spaghetti squash.


Meanwhile, heat a skillet over medium high heat. Brown the turkey sausage until cooked through.


Toss together the spaghetti squash, pesto, and sausage. Scoop back into spaghetti squash halves. Top with shredded cheese and broil for 3-4 minutes to melt the cheese. Top with fresh tomatoes if desired.

Nutritional Facts
Serving Size: 1/2 spaghetti squash
Amount Per Serving
Calories 352
Calories from Fat 165
% Daily Value *
Total Fat 19g
Saturated Fat 5g
Monounsaturated Fat 1g
Polyunsaturated Fat 0g
Cholesterol 95mg
Sodium 922mg
Total Carbohydrate 21g
Dietary Fiber 5g
Sugars 8g
Protein 28g

* Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs.

The Nutritional Values provided are estimates only and may vary based on the preparation method.

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About the author Meet Kristen McCaffrey
Hi, I’m the cookbook author, recipe developer, and food enthusiast behind Slender Kitchen. I am obsessed with making healthy food that is easy to prepare and absolutely delicious. Meal planning is my secret weapon and I hope I can make meal time easier for you with our tried and tested recipes and foolproof meal plans. Learn More
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