Enjoy these Keto Italian Meatballs that are braised low and slow in a classic tomato sauce guilt-free! They’re finished off baked in the oven with gooey mozzarella cheese.

❤️ Why You’ll Love This Keto Italian Meatballs Recipe

• Tender and flavorful classic Italian meatballs
• Braised low and slow in a tangy low carb tomato sauce
• Baked melted mozzarella cheese on top
• Family friendly

Oh how I love the smell of Italian food cooking in my kitchen!  And who doesn’t love a great meatball parmigiana!? Before Keto, I often made the typical “Sunday Sauce” (or gravy depending on who you ask!) and of course served it over some of my favorite pasta long fusilli, rigatoni or penne.  

While I no longer indulge in pasta, I do still really enjoy a good meatball, Italian sausage or Beef Braciole.  This is such a healthy Low Carb meatball recipe that will make you forget that you are on a diet!

With shredded mozzarella cheese over the top, they’re baked in the oven till the cheese is golden and bubbly.  These are the best gluten free meatballs ever, and I promise you won’t even miss the bread crumbs!  They are moist, tender and full of flavor!

🛒 What’s in Low Carb Italian Meatballs

• Ground beef
• Ground pork
• Parmesan cheese
• Mozzarella cheese
• Low carb tomato sauce
• Tomato paste
• Oat fiber
• Eggs
• Heavy cream
• Garlic
• Basil
• White wine (or chicken stock)
• Salt
• Ground black pepper
• Olive oil 

*Exact measurements are listed in the recipe card below.

🥣 Recommended Tools

• Large skillet
• Ice cream scoop
• Parchment paper
• Mixing bowl

🔪 How to Make the Best Keto Meatballs

Add eggs, heavy cream, 3 cloves of the garlic, parmesan cheese, tomato paste, oat fiber and half the basil to a mixing bowl and mix well.  

Using an ice cream scoop, scoop out mixture into your hand, form the meatballs and place them on a piece of parchment paper.  

Wet your hands periodically, to prevent them from sticking to your hands.

Heat a large nonstick skillet to medium. Add in the olive oil and once heated, add in the meatballs.

Sear on all sides, and cook until they firm up.

Remove the meatballs and put them aside.

Drain off most of the fat, then add in the remaining clove of garlic. Sauté for about 20 seconds, careful not to brown it. Deglaze the pan with the wine, scraping up the brown bits. Continue cooking until the liquid has reduced by half. Stir in the tomato sauce, remaining basil, salt and pepper.

Add the meatballs back in and cook (covered) for 1 hour on low or until tender.  

You can either serve the meatballs as is with the sauce over the tops or you can bake them with some cheese.

Preheat the oven to 425°F.  Add the cheese over the top.

Bake for 10 minutes or until the cheese is golden, then serve.

💡 Tips to Make the Best Keto Meatballs

• Mix everything that goes into the meatballs in the bowl first and add in the meat last, this ensures the meat does not get overworked, tough and dense.  
• Using an ice cream scoop makes the meatballs more uniform in size and helps them all cook evenly.  And let’s be honest, much easier than digging your hands in the bowl each time!
• Most definitely use a nonstick pan! Since this recipe doesn’t use breadcrumbs, they are a little more delicate and can stick more easily to a stainless steel pan.
• Braising them low and slow in the tomato sauce helps keep them tender, while infusing great flavor into the meatballs.

☑️ Storage Instructions

Store leftover meatballs in an airtight container for 3-4 days in the fridge or freeze.

🍴 What Can I Serve with Italian Meatballs Instead of Pasta?

There are several different ways you can serve these meatballs that are perfectly acceptable for a low carb diet. The first and most traditional, would be over a bed of zucchini noodles, Palmini noodles or this Parmesan Garlic Spaghetti Squash.

The second, is with Keto Buns or Keto Dinner Rolls, and for added flavor Keto Garlic Rolls are fantastic! But my favorite is with these homemade Keto Hot Dog Buns that you see below. I simply made a batch of 6, rather than the 8 in the recipe and they were the absolute perfect size!

You can also serve them a some sauce on top and a low carb side dish or salad on the side.

🔄 Substitutions and Additions

• If you only have crushed tomatoes on hand, you can use them instead of tomato sauce.
• If you don’t have fresh basil, you can use some fresh parsley and a little dried basil.
• Grated Romano or Asiago can be used instead of parmesan cheese.
• Finely ground almond flour can be used instead of the oat fiber, though it will change the texture a bit. I would use 1/4 cup instead of the 1 tablespoon of oat fiber, since it’s not nearly as absorbent.
• Chicken stock can be used instead of white wine if you’d like.
• The tomato paste helps give the meatballs more flavor and helps keep them moist. If you don’t have tomato paste, you can use the same amount of tomato sauce instead.

Can you Eat Italian Food on Keto?

Yes, you sure can! While we cannot enjoy traditional pasta, there are a number of classic Italian dishes that with a few ingredient tweaks, that we can indulge in. Here are some of my favorite Keto Italian recipes:

• Zucchini Rollatini
• Crockpot Sausage and Peppers
• Chicken Piccata
• Creamy Tuscan Chicken Skillet
• Keto Marinara Sauce

Can You Substitute Almond Flour for Bread Crumbs to Make This Gluten-Free Meatball Recipe?

Sure you can, but this meatball recipe is made without breadcrumbs.  It uses 1 cup of parmesan cheese instead and actually acts as the perfect binder, along with the eggs.

Can you Eat Meatballs on Keto Diet?

With this Keto meatballs recipe, there is no reason you can’t enjoy the same great flavor and texture of traditional meatballs. And because, as I explain below, they are made with almond flour instead of all purpose flour, they are perfectly low carb!

In fact, in recipes that use bread crumbs, like Chicken Parmesan, Zucchini Fries, Chicken Milanese or Mozzarella Sticks,  I make my own gluten free breadcrumbs with a mix of almond flour, parmesan cheese and crushed pork rinds and herbs, which works really well.

There is also heavy cream in the mix, this is to keep them moist and tender.  

How Many Net Carbs are in Keto Meatballs?

Each serving in this Keto meatball recipe, has only 3 net carbs.  This includes a little sauce over the top, which is a must!

What Frozen Meatballs are Keto Friendly?

Store bought frozen meatballs typically contain flour in them, as one of the binding agents used to hold them together. So they’re not idea for a low carb or Keto diet. However, since this meatball recipe ues almond flour instead, they are perfectly acceptable and can easily be frozen.

Is Almond Flour Good for Keto?

Absolutely and it does a great job in holding the meatballs together, just as all purpose flour does with traditional meatballs. I do find that the oat fiber I used in this recipe does work better than almond flour.

How Should You Store these Almond Flour Meatballs?

Store them in the fridge for a few days, sitting in their sauce so they can continue to absorb the flavor and stay moist.  This is one of those meals that actually tastes better the next day.  Beyond a few days, you can freeze them and they’ll reheat beautifully!

🍽️ More Keto Ground Beef Recipes

• Bacon Cheeseburger Casserole
• Baked Southwest Skillet
• Beef Stroganoff Casserole
• Instant Pot No-Bean Chili
• Chili Cheese Dog Casserole

*Originally published on September 12, 2018, updated on May 7, 2024 with improvements to the recipe, new photos, new recipe information and helpful tips.