Love sausage but you’re tired of same-old same-old? This keto Sausage Stew is loaded with big chunks of sausage, oodles of flavor, and plenty of veggies — it is one deliciously different stew.

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I love the versatility here, I change up the sausage variety depending on my mood, and serve it with pasta for the kids while I eat mine over mashed cauliflower.
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Chef Jenn’s Take on Keto Sausage Stew
Cook the sausage in water first, with the water coming about halfway up the sides, rather than starting with a dry sear. It keeps the sausage moist and actually speeds up the process.
Turn the sausage once or twice while it cooks in the water, then let it cool slightly before slicing. Add it to the same skillet where you sauteed the onion, garlic, and peppers. You do not need flavored sausage for this, so much flavor gets built in along the way that a plain, good quality sausage works just as well. Mild Italian sausage is my first pick, hot Italian if you want something spicier. If the stew ends up too thick, thin it out with a few spoons of water.
Smoked hot paprika adds a genuinely distinctive flavor worth seeking out, though cayenne or red chili flakes work as substitutes if you cannot find it. Crushed tomatoes and tomato puree are the same thing, and tomato sauce works too, just watch the sugar content. One recent reader added mushrooms, cut back the Italian seasoning slightly, and tried smoked paprika for the first time, and loved how it turned out.

What You’ll Love About Keto Sausage Stew
- Flexible enough to change up the sausage variety anytime you want.
- A genuinely different way to enjoy sausage, big chunks and real flavor.
- Ready in about 30 minutes, real weeknight speed.
Ingredients

- Mild Italian sausage – Hot Italian sausage works if you want it spicier. Plain sausage is fine, you’ll be adding plenty of flavor along the way.
- Onion – Sliced.
- Garlic – Minced.
- Red and green bell peppers – Sliced.
- Crushed tomatoes – Canned. Tomato sauce works too, watch the sugar content.
- Paprika and smoked hot paprika – Cayenne or red chili flakes work as a substitute for the smoked hot paprika.
- Italian seasoning – Check the label for hidden sugar.
- Avocado oil – Or your favorite cooking oil.
- Red pepper flakes
How to Make Keto Sausage Stew
Scroll down for the full recipe card with exact measurements and printable instructions.
Cook the sausage in a large skillet with enough water to come halfway up the sides. Turn once or twice until cooked through. Set aside.

In the same skillet, sautee the onion and garlic in the avocado oil over medium-high heat, until the onion is soft, about 4 minutes. Add the peppers and cook a minute longer.

Let the sausage cool slightly, then slice it and add it to the skillet with the onions and peppers. Add the spices and mix well.

Add the crushed tomatoes and stir completely. Simmer covered for about 15 minutes, until thick.

Serve and enjoy.

Make It A Meal
Spoon this over Cheesy Mashed Cauliflower for the full experience, or eat it as-is with a salad or Broccoli with Garlic & Parmesan.
For more hearty stews, Chicken Cacciatore and Keto Beef Stew are both worth adding to the rotation.

Storage
Chill fully, then freeze in zipper-top freezer bags or freezer-safe containers, or silicone freezer trays if you have them, for up to 3 months. Thaw and reheat in the microwave or on the stovetop.
Frequently Asked Questions
This simple recipe can be on the table in about 30 minutes. Cooking the sausage first in water keeps the sausage moist and speeds up the cooking process.
I prefer using a mild Italian sausage but you can use whatever you like. Just watch for hidden carbs found in fillers in the sausage.
This easy peasy dish only has 6 net carbs in it, making it a great choice for keto and low-carb diets.
Keto Sausage Stew
Ingredients
- 1 pound mild Italian sausage
- 1/2 cup onion sliced
- 2 cloves garlic minced
- 1/2 cup red bell pepper sliced
- 1 cup green bell pepper sliced
- 14 ounces crushed tomatoes canned
- 1/4 teaspoon paprika
- 1/4 teaspoon smoked hot paprika
- 1 tablespoon Italian seasoning
- 1/4 teaspoon salt
- 2 tablespoons avocado oil
Instructions
- Cook the sausage in a large skillet with enough water that the water comes halfway up the sausage. Turn them once or twice until they are cooked through. Set aside.
- In the same skillet, sautee the onion and garlic over medium high heat in the avocado oil. Cook until the onion is soft, about 4 minutes. Add the peppers and cook a minute longer.
- Slice the sausage and add it to the skillet with the onions and peppers. Add the spices and mix well.
- Add the tomato sauce and stir completely. Simmer covered for about 15 minutes until the stew is thick and delicious. Serve and enjoy!
Notes
Recipe Card Tips
- Cook the sausage in water first, rather than starting with a dry sear, it keeps it moist and speeds up the process.
- Let the sausage cool slightly before slicing it, for cleaner, easier cuts.
- Thin the stew with a few spoons of water if it ends up too thick.
Nutrition
A Note on Nutritional Information
Nutritional information for this recipe is provided as a courtesy and is calculated based on available online ingredient information. It is only an approximate value. The accuracy of the nutritional information for any recipe on this site cannot be guaranteed. Erythritol carbs (sugar substitutes) are not included in the carbohydrate counts as they have been shown not to impact blood sugar, and they have zero calories and zero carbs. Net carbs are the total carbs minus fiber.









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Love all the flavors here, I already know I’m going to enjoy this recipe a lot!
I do love sausage and I am tired of the same-old-same-old. This is a perfect change of pace!
I love the simplicity of this dish yet I can tell it’s loaded with flavors, too! So good!
Looks hearty, comforting and delicious! Would make a fantastic weeknight meal!
I love how hearty this keto stew is! I can’t wait to give this a try next week. I just added it to my menu.
I really loved it! Very simple, versatile and delicious! I added mushrooms and reduced the Italian seasoning a little. This was my first time using smoked paprika, and it certainly contributed to the success of the recipe. Thank you!
Smoked paprika is my new favorite, and my secret weapon! I’m so glad you loved it, and thanks for coming back to comment! ~Jenn