Keto Sausage Gravy

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This Keto Sausage Gravy recipe is so easy to make and is incredibly flavorful. Mild Italian sausage, cooked with onions and garlic, in a rich and creamy gravy made with heavy cream and parmesan cheese. It comes together in less than 30 minutes and only dirties one pan. (Low carb, keto, gluten free)

A white ceramic plate with homemade cheddar dill biscuits topped with sausage gravy, paprika and chives.

Table of Contents show

Ingredients in Keto Sausage Gravy

Ingredients all laid out to make sausage gravy - sausage, heavy cream, butter, garlic, herbs, salt, pepper, onion, and parmesan cheese.

Ingredients Notes and Substitutions

Ground Italian pork sausage: For this recipe I used a ground mild Italian sausage. You can also use a spicy ground Italian sausage or even sliced sausage links.
Heavy cream: The heavy cream made this keto sausage gravy thick and rich without using flour to thicken it. You can use half and half in place of the heavy cream, but you may need to add a little xanthan gum to help thicken the gravy. Alternatively, you could add a little cream cheese to help thicken it as well.
Parmesan cheese: The parmesan cheese also helps to thicken the gravy and adds a nice umami flavor to the gravy.
Onion: For this recipe I use sweet onions, but you can also use white onions, red onions, or even shallots.
Garlic: Fresh is always best, but if you do not have any fresh garlic on hand, you can use garlic powder or dried minced garlic.

How to Make Keto Sausage Gravy

A cast iron skillet with chopped onions sautéing in butter.

Step by Step Instructions

STEP 1: Heat the butter in a large skillet over medium heat. Once the butter is melted, add the onion and cook until soft and translucent. Add the garlic and cook until fragrant.

a cast iron skillet with ground Italian sausage cooking in it.

STEP 2: Add the sausage, salt, and pepper to the pan and cook until browned. Drain all excess grease from pan. This is important or the gravy will be oily.

a cast iron skillet with a rich creamy base for gravy cooking.

STEP 3: To the pan, add the heavy cream, parmesan and parsley. Increase the heat to medium-high and whisk as it comes to bring to a boil. Once the gravy begins to boil, reduce the heat to low and simmer. Once the gravy begins to thicken, add the sausage back to the pan.

A cast iron skillet with a freshly made batch of gluten free sausage.

Recipe Tips and Variations

Storage: Store leftover keto sausage gravy in the refrigerator for up to 5 days.
Reheating: I recommend reheating in a pan on the stovetop. Adding a little extra cream or even some chicken broth with help the gravy come back to life.
Omit the sausage: Leave out the pork sausage and you have a delicious version of white gravy, also known as country gravy.
Change the protein: This keto gravy is also delicious made with ground beef, chicken, or even turkey.
Serving suggestions: This low carb sausage gravy is excellent served over top of cauliflower mash, zucchini noodles, cauliflower rice, and of course keto biscuits. I've linked some of my favorite low carb biscuits recipes below.

Frequently Asked Questions

Can you make sausage gravy ahead of time?

Yes! If making ahead of time, you made need to add a little extra cream or chicken stock when reheating to help bring it back to life.

How do you make dairy free sausage gravy?

To make this recipe dairy free, substitute the heavy cream with and equal amount of full fat coconut milk and the parmesan cheese with 3 tablespoons of nutritional yeast. You may also need to add a little thickener like xanthan gum or arrowroot powder.

What to Serve with Gluten Free Sausage Gravy

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