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Spaghetti Squash and Meatballs

I’m coming at you with a delightful fall recipe for spaghetti squash and meatballs that you’re guaranteed to love.

It comes with the best ever creamy tomato sauce, making an amazingly nutritious and comforting meal.

Overhead shot of finished Spaghetti Squash with Italian Meatballs & Creamy Tomato Sauce

How to make spaghetti squash and meatballs

For the spaghetti squash:

  • Spaghetti squash: The star of the dish.
    • My recipe explains how to make spaghetti squash in the microwave, but you can also roast it in the oven or make it in a pressure cooker.

For the creamy tomato sauce:

  • Olive oil: To saute the onion and garlic and provide that classic olive oil flavor.
  • Onion and garlic: Aromatics to make for an excellent sauce.
  • Herbs and spices: Dried Italian seasoning, oregano, crushed red pepper flakes, salt and black pepper.
  • Tomatoes: San Marzano canned tomatoes are the best for making tomato sauce, as they’re sweet and delicious.
  • Basil: Fresh basil makes the sauce extra herby and provides that classic fresh basil flavor.
  • Sugar: Just a pinch balances the acidity of the tomatoes.
  • Cream cheese: Just a little bit adds rich creaminess.

For the Italian meatballs:

  • Ground meat: I like to use a mix of lean ground beef and Italian sausage or ground pork to make the meatballs.
  • Eggs and breadcrumbs: To hold everything together. Panko breadcrumbs are light and fluffy.
  • Parmesan: I use freshly grated Parmesan in the meatball mixture plus some for serving.
  • Dijon: My secret weapon in meatballs. It provides flavor and moisture.
  • Herbs and spices: Dried oregano leaves, salt and black pepper for ultimate flavor.

For the garnishes:

  • Parmesan: Freshly grated.
  • Parsley: Freshly chopped.
Creamy Tomato Sauce in a white pot.

Step-by-Step Instructions

For the spaghetti squash:

  1. Slice the spaghetti squash in half and scoop out the seeds.
  2. Place face-down in a baking dish. Pour ½ cup water into the dish.
  3. Microwave on high 10-12 minutes, or until fork-tender or bake at 400 degrees for 45-60 minutes, or until fork-tender. 
  4. Let slightly cool, then use a fork to loosen strands of squash.
  5. For serving, leave squash strands in the shell or remove and place in bowls.

For the tomato sauce:

  1. Heat the olive oil in a Dutch oven or high-sided pan to medium-low heat.
  2. Add the onion and sauté 6-7 minutes or until soft.
  3. Stir in the garlic, Italian seasoning and oregano.
  4. Add the tomatoes and fresh basil and bring to a simmer. Crush the tomatoes with a wooden spoon, then let simmer 10-15 minutes.
  5. Stir in the salt and black pepper.
  6. Use an immersion blender to puree the sauce until very smooth, or transfer mixture to a blender and puree until very smooth. 
  7. Stir in the sugar and cream cheese until cream cheese is melted
  8. Taste and adjust seasoning, if necessary.

For the meatballs:

  1. Preheat the oven to 375 degrees. Fit a baking sheet with a wire rack and coat with cooking spray.
  2. Place all the ingredients into a large bowl and mix with your hands until ingredients are thoroughly combined.
  3. Form into 2-inch meatballs and place on the prepared rack.
  4. Bake 17-20 minutes or until meatballs are set and internal temperature reaches 155 degrees.

To serve:

  1. Serve spaghetti squash with meatballs and creamy tomato sauce, and garnish with chopped parsley and Parmesan cheese.
Overhead shot of Italian Meatballs in a White Bowl

Recipe Substitutions and Alterations

  • For the spaghetti squash: You can use regular spaghetti pasta instead of spaghetti squash.
  • For the tomatoes: If you don’t have San Marzano, regular canned whole or diced tomatoes will work.
  • For the cream cheese: Use a few tablespoons of half and half or cream instead, or skip it altogether.
  • For the ground meat: Use any combination of ground beef, pork, turkey or chicken.
  • For the breadcrumbs: Regular or Italian breadcrumbs will work if that’s what you have on hand.

Nutrition Considerations

  • To make it gluten free: Use gluten free panko or regular breadcrumbs. Be sure all other ingredients are gluten free.
  • To make it dairy free: Skip the cream cheese and Parmesan.
  • To make it nut free: This recipe does not contain nuts. Be sure all packaged ingredients are nut free.
  • To make it egg free: Try an egg replacer or flax ‘eggs’ in the meatballs (although I haven’t tested this).
Spaghetti Squash with Italian Meatballs & Creamy Tomato Sauce

Comfort food recipes:

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Spaghetti Squash with Meatballs

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Roasted spaghetti squash with Italian beef meatballs and creamy homemade tomato basil sauce.

  • Author: Julie Andrews
  • Prep Time: 20-25 mins
  • Cook Time: 40-45 mins
  • Total Time: 1 hr-1 hr 10 mins
  • Yield: Serves 8
  • Category: Dinner
  • Method: Microwave, Baking, Stove-Top
  • Cuisine: Italian

Ingredients

Scale

Spaghetti Squash:

  • 2 medium spaghetti squashes*

Creamy Tomato Sauce:

  • 1 tablespoon olive oil
  • ½ medium yellow or white onion, peeled and diced
  • 23 cloves garlic, peeled and minced
  • 1 tablespoon Italian seasoning
  • ½ tablespoon dried oregano leaves
  • 1 (32-ounce) can whole San Marzano tomatoes
  • ¼ cup fresh basil leaves
  • 1 teaspoon coarse salt
  • ½ teaspoon freshly ground black pepper
  • ¼ teaspoon crushed red pepper flakes
  • 1 ½ teaspoons granulated sugar
  • 2-ounces (about ¼ cup) cream cheese

Italian Meatballs:

  • ½-pound lean ground beef
  • ½-pound ground Italian sausage or ground pork
  • 2 large eggs
  • ½ cup Panko breadcrumbs
  • 2 tablespoons freshly grated Parmesan
  • 1 tablespoon Dijon mustard
  • ½ tablespoon dried oregano leaves
  • ½ teaspoon coarse salt
  • ¼ teaspoon ground black pepper

Garnishes:

  • ¼ cup freshly grated Parmesan cheese
  • ¼ cup flat-leaf Italian parsley, chopped

Instructions

For the spaghetti squash:

  1. Slice the spaghetti squash in half and scoop out the seeds. Place face-down in a baking dish. Pour ½ cup water into the dish. Microwave on high 10-12 minutes, or until fork-tender or bake at 400 degrees for 45-60 minutes, or until fork-tender. 
  2. Let slightly cool, then use a fork to loosen strands of squash.  For serving, leave squash strands in the shell or remove and place in bowls.

For the tomato sauce:

  1. Heat the olive oil in a Dutch oven or high-sided pan to medium-low heat. Add the onion and sauté 6-7 minutes or until soft. Stir in the garlic, Italian seasoning and oregano.
  2. Add the tomatoes and fresh basil and bring to a simmer. Crush the tomatoes with a wooden spoon, then let simmer 10-15 minutes. Stir in the salt and black pepper.
  3. Use an immersion blender to puree the sauce until very smooth, or transfer mixture to a blender and puree until very smooth. 
  4. Stir in the sugar and cream cheese until cream cheese is melted. Taste and adjust seasoning, if necessary.

For the meatballs:

  1. Preheat the oven to 375 degrees. Fit a baking sheet with a wire rack and coat with cooking spray.
  2. Place all the ingredients into a large bowl and mix with your hands until ingredients are thoroughly combined.
  3. Form into 2-inch meatballs and place on the prepared rack. Bake 17-20 minutes or until meatballs are set and internal temperature reaches 155 degrees.

To serve:

  1. Serve spaghetti squash with meatballs and creamy tomato sauce, and garnish with chopped parsley and Parmesan cheese.

Notes

Cooking Tip: The spaghetti squash can be cooked in the oven @ 400 degrees for about an hour, or until fork tender.

Nutrition

  • Serving Size: 1/8 of recipe
  • Calories: 275
  • Sugar: 24g
  • Sodium: 586mg
  • Fat: 18g
  • Saturated Fat: 4.5g
  • Unsaturated Fat: 13.5g
  • Trans Fat: 0g
  • Carbohydrates: 41g
  • Fiber: 11.5g
  • Protein: 20.5g
  • Cholesterol: 88.5mg

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