Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (2024)

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This is the best paleo meatball recipe you’ll ever make! Homemade Whole30 meatballs, full of meat and veggies, are smothered in a creamy tomato sauce for a satisfying Italian dinner that’s also dairy-free and low-carb.

Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (1)

What Makes This Recipe So Good

  • They’re made with shredded zucchini, which keeps the meatballs super tender, plus ups your daily veggie intake (and the kids will never even know it’s there!).
  • The creamy tomato sauce is super simple but also kind of life-changing. The coconut cream cuts the tomato’s acidity just enough to make you want to treat the sauce left in the bowl as a soup… Slurp up, my friends.
  • These Italian paleo meatballs are actually quite easy to make, especially if you use a disher to portion out the individual meatballs, so they’re fantastic for meal prep. They keep so well, too!

Is your Whole30 M.O. like ours? In my house, the month of squeaky clean eating and elimination of allergenic foods could otherwise be called “The Month of Meatballs.” They’re just so easy to throw together for a dinner or to meal prep for the week, aren’t they? To dip in Whole30 dump ranch or stir into a creamy sauce. Oh, oh oh.

Meaning your girl is pretty well versed when it comes to the paleo meatballs out there, and Italian paleo meatballs are no exception. So you should know when I make this claim that I’mreally saying something:

These are the best ever Italian paleo meatballs.

Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (2)

How to Make Them

The full recipe & ingredients list are below, but here you’ll find a quick overview for making this recipe perfectly, along with useful tips and info!

Mix together all meatball ingredients.

Use a disher to portion out the meatballs and roll slightly to form even spheres. If you don’t have a disher, use a spoon to try and portion out the meatballs mixture evenly then roll between your palms.

Fry meatballs in coconut or avocado oil in a large skillet, working in batches. Transfer to a plate.

Sauté garlic in the same pan, adding a bit of oil, then add remaining sauce ingredients. Bring to a low boil and reduce heat slightly; simmer until a bit thickened. Return meatballs to skillet and simmer a couple minutes in sauce. Serve over zoodles or alone!

Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (3)

Chef’s Tips

  • This recipe makes a good amount of sauce, because sauce = life. However, you can cut things down to 1 can crushed tomatoes and 1/2 cup coconut cream, if you prefer. Simply neatly halve the sauce ingredients, and there you go!
  • Use a food processor with a shredding blade attached to make prepping the zucchini super easy.
  • Chop the spinach pretty fine so it blends beautifully with the meat mixture.
  • Use a disher to evenly and quickly portion out the meatballs. I like this one.

Variations

  • Use ground chicken or beef in place of the ground pork in this recipe. I prefer chicken and pork for these Italian Whole30 meatballs, since it stays more tender in my opinion, but a ground beef that’s not too terribly lean would be good, too!
  • Swap out the chopped spinach for chopped chard leaves or even kale!
  • Increase the coconut cream for an even creamier tomato sauce.
Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (4)

More Paleo Recipes You’ll Love

  • Whole30 Zuppa Toscana
  • Chimichurri Whole30 Meatballs with Swiss Chard
  • Sweet Potato Rice
  • Whole30 Chicken Bacon Ranch Poppers
  • Bruschetta Chicken (Whole30, Paleo, Low Carb)

Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (5)

5 from 25 votes

Best Ever Italian Paleo Meatballs with Creamy Tomato Sauce


Prep 10 minutes minutes

Cook 30 minutes minutes

Total 40 minutes minutes

Tender Italian paleo meatballs loaded with veggies and flavor, served with a rich, creamy, garlicky tomato sauce. Whole30 and low carb.

8 servings

Ingredients

Italian Paleo Meatballs

  • 1 pound ground pork
  • 1 pound ground chicken or more ground pork
  • 2 cups shredded zucchini
  • 2 cups chopped fresh spinach
  • 2 cloves garlic minced
  • 1 ½ teaspoons Italian seasoning
  • 1 teaspoon salt
  • refined coconut oil or avocado oil for frying

Creamy Tomato Sauce

  • 2 teaspoons avocado or refined coconut oil
  • 4 cloves garlic
  • 2 14-ounce cans crushed tomatoes
  • 1 cup coconut cream just the solid white part from 1-2 cans of coconut cream or milk
  • 2 teaspoons Italian seasoning
  • 1 – 1 ½ teaspoons salt
  • fresh chopped parsley for garnish

Instructions

  • Combine all meatball ingredients in a large mixing bowl and mix until combined well, using your hands. Do not overmix.

    Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (6)

  • Use a disher and portion out meatball mixture into even balls; repeat until all meatball mixture is used.

    Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (7)

  • Heat a layer of refined coconut or avocado oil in a large skillet over medium heat. Fry meatballs in batches until brown on all sides and cooked through. Transfer to a plate.

    Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (8)

  • Pour out oil if excess remains. Add 2 teaspoons avocado or refined coconut oil to skillet over medium-low heat. Add garlic and, stirring constantly, cook until fragrant, about 30 seconds.

    Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (9)

  • Add remaining sauce ingredients and stir to combine well. Bring to a low boil then reduce heat slightly and simmer for about 5-10 minutes or until a bit thickened.

    Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (10)

  • Return meatballs to skillet and simmer 3-5 minutes to absorb sauce. Serve over zoodles or alone and top with fresh chopped parsley.

    Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (11)

Video

For a dish with less sauce, use 1 teaspoon oil, 2 cloves garlic, 1 can crushed tomatoes, 1/2 cup coconut cream, 1 teaspoon Italian seasoning, and 1/2 to 3/4 teaspoons salt.

Approximate Information for One Serving

Calories: 414calProtein: 23gFat: 32gSaturated Fat: 18gCholesterol: 89mgSodium: 502mgPotassium: 997mgTotal Carbs: 12gFiber: 3gSugar: 5gNet Carbs: 9gVitamin A: 1000IUVitamin C: 19.1mgCalcium: 80mgIron: 3.7mg

Nutrition Disclaimers
Number of total servings shown is approximate. Actual number of servings will depend on your preferred portion sizes.
Nutritional values shown are general guidelines and reflect information for 1 serving using the ingredients listed, not including any optional ingredients. Actual macros may vary slightly depending on specific brands and types of ingredients used.
To determine the weight of one serving, prepare the recipe as instructed. Weigh the finished recipe, then divide the weight of the finished recipe (not including the weight of the container the food is in) by the desired number of servings. Result will be the weight of one serving.

Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (12)

Cheryl Malik

In addition to being a certified health coach, certified yoga instructor, and mom of 3, Cheryl is also the recipe developer, editor-in-chief, food photographer, and passionate foodie behind 40 Aprons. Having spent the last 10+ years as a food blogger, she's become known for her flavorful recipes, detailed instructions, gorgeous photography, and down-to-earth approach to food and cooking in general.

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  1. The recipe doesn’t lie. These are the best ever meatballs and sauce! I love that I can hide the veggies in them for my picky family members. I bake the meatballs instead of pan frying!Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (13)

    Reply

    1. Ooh, love the idea of baking them! Thanks for sharing! 🙂

      Reply

  2. I was nervous about trying these. I’m not a fan of zucchini. These meatballs were SO GOOD! I air fried them for 12 mins on 400, flipping halfway through! Will be making these again. Thank you so much.Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (14)

    Reply

    1. So glad you loved them Courtney!Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (15)

      Reply

  3. This was so good. All my people loved it. We will be making this again…

    Reply

    1. Such a great weeknight dinner. Thanks Sheila!Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (16)

      Reply

  4. How much is a serving? How can I make these keto friendly?

    Reply

    1. We consider a serving to be anywhere between 4-6 ounces. These meatballs are keto friendly 🙂Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (17)

      Reply

  5. Made this tonight – it was DELICIOUS!!! I had mine over steamed cauliflower and it was very good!!! Will make this again for sure!Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (18)

    Reply

  6. These are so yummy! We made them and decided to bake them in the oven on one sheet pan instead of having to brown them all in a skillet. I also did not have crushed tomatoes, so we used a jar of whole 30 approved marinara type sauce instead for the sauce and turned out well.Best Ever Paleo Italian Meatballs with Creamy Tomato Sauce (Whole30, Low Carb) (19)

    Reply

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Meet Cheryl

Passionate foodie, certified health coach, serial entrepreneur, and mom of 3.

I've been developing and sharing delicious, approachable recipes on 40 Aprons for more than a decade. My goal is simple: take the chore out of mealtime by creating recipes that anyone can cook and that never skimp on flavor.

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