Italian Sausage Balls Appetizer Made with Almond Flour

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Italian sausage, mozzarella cheese, pepperoni come together with almond flour and eggs for the most delicious appetizer, after school snack or brunch item.

While I have a good low-carb, traditional sausage ball recipe here, made with breakfast sausage and cheddar, this stands out above the norm. When a reader recently commented how these sausage balls turned out, I thought I’d try a different take and make these Italian style.

I had to add pepperoni for zing and of course use Italian sausage and mozzarella.

Italian Sausage Balls Ingredients

  • Loose Italian sausage
  • pepperoni
  • almond flour
  • egg
  • mozzarella cheese

I actually made two different kinds to see which I would like better. One batch was made with cream cheese, and one batch with eggs.

Egg Free Option

The recipe with eggs was more tender, easier to make and all around better. However, you wanted an egg free sausage ball, mix in 4 tablespoons cream cheese in place of the eggs.


You should be able to get about 24 to 26 sausage balls at 1 carb each, making this the perfect low-carb appetizer, but delicious enough for anyone and great for folks needing a gluten free option.

Italian Sausage Balls Cooking Process

  • Bring all ingredients together, but try not compact the sausage, which can make the balls tough.
  • Roll into balls
  • Bake at 350 degrees F, 180 C. for about 15 minutes.
  • Cool on paper towels.

The best thing about these is that you can freeze these uncooked ahead and always have an appetizer ready to go in 15 minutes.

Freezing Process

  • Roll out onto a tray. Freeze UNCOOKED.
  • Once frozen, place in plastic freezer bag.
  • Bake frozen 15-20 minutes.

You may or may not want to serve with pizza sauce. We like them just by themselves, but a dipping tomato sauce could be good too.

Optional Pizza Sauce

You can serve these with my pizza sauce if desired.

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5 from 2 votes

Italian Sausage Balls Appetizer

Delicious appetizer or brunch item, keto friendly, gluten free, grain free, Italian sausage with mozzarella, almond flour, pepperoni.
Prep Time10 minutes
Cook Time15 minutes
Course: Appetizer
Cuisine: Italian
Keyword: Italian sausage, sausage balls
Servings: 24 sausage balls
Calories: 72kcal


  • 1 pound Mild Italian Sausage
  • 1 cup almond flour or 1 1/3 cups regular flour
  • 2 small eggs beaten
  • 2 cups whole milk mozzarella cheese shredded
  • 10 pieces pepperoni, chopped (about 1/2 cup loosely packed)


  • Preheat oven to 350 degrees F, 180 C
  • Mix by hand all Ingredients.
  • Using small sized scoop, roll out 24-26 sausage balls.
  • Place on baking sheet. Bake for 13-15 minutes.

To Freeze

  • Arrange UNCOOKED on tray and freeze. Once frozen, place In freezer ziplock bag.
  • When ready to bake, bake frozen, 15 to 20 minutes. Check at 15.


Calories: 72kcal | Carbohydrates: 1g | Protein: 6g | Fat: -16g

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If you love this recipe, please give it five stars. It means a lot. xoxo

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  1. 5 stars
    Made these to take to Super Bowl party. They turned out great and everyone wanted to know all about them. Big hit and tasted great. Thanks for the recipe.

5 from 2 votes

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