Italian Whole30 meatballs in creamy tomato sauce in a skillet on a dish towel

Best Ever Italian Paleo Meatballs with Creamy Tomato Sauce

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

Course Main Course
Cuisine Italian
Keyword italian, meatballs, paleo
Prep Time 10 minutes
Cook Time 30 minutes
Total Time 40 minutes
Servings 8 servings
Calories 414 kcal


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 1/2 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 1/2 teaspoons salt
  • fresh chopped parsley for garnish


  1. Combine all meatball ingredients in a large mixing bowl and mix until combined well, using your hands. Do not overmix.
  2. Use a disher and portion out meatball mixture into even balls; repeat until all meatball mixture is used.
  3. Heat a layer of refined coconut or avocado oil in a large skillet over medium heat. Fry meatballs in batches until browned on all sides and cooked through. Transfer to a plate.
  4. Pour out oil if excess remains. Add 2 teaspoons avocado or refined coconut oil to skillet over medium-low heat.
  5. Add garlic and, stirring constantly, cook until fragrant, about 30 seconds. 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. Return meatballs to skillet and simmer 3-5 minutes to absorb sauce.
  6. Serve over zoodles or alone and top with fresh chopped parsley.

Recipe Video

Recipe Notes

You can half the sauce ingredients if you prefer a less saucy dish. Use 1 teaspoon oil 2 cloves garlic 1 can crushed tomatoes 1/2 cup coconut cream 1 teaspoon Italian seasoning 1/2 - 3/4 teaspoons salt

Nutrition Facts
Best Ever Italian Paleo Meatballs with Creamy Tomato Sauce
Amount Per Serving
Calories 414 Calories from Fat 288
% Daily Value*
Fat 32g49%
Saturated Fat 18g113%
Cholesterol 89mg30%
Sodium 502mg22%
Potassium 997mg28%
Carbohydrates 12g4%
Fiber 3g13%
Sugar 5g6%
Protein 23g46%
Vitamin A 1000IU20%
Vitamin C 19.1mg23%
Calcium 80mg8%
Iron 3.7mg21%
* Percent Daily Values are based on a 2000 calorie diet.