Sicilian Meatballs with Zucchini Fettuccine
Servings Prep Time
8people 40minutes
Cook Time
Servings Prep Time
8people 40minutes
Cook Time
  • 1 1/2pounds ground beef20% fat, can substitute ground turkey
  • 2large sweet italian pork sausagesmeat removed from casing, can substitute turkey Italian sausage
  • 1 medium onionfinely minced
  • 5 garlic clovesfinely minced
  • 2 eggsbeaten
  • 1/3cup almond meal
  • 1tablespoon tamari sauce
  • 3tablespoons milkcan substitute almond milk, half and half, or cream for Keto
  • 4tablespoons fresh parsleyfinely minced – reserve 1 tablespoon for plating
  • 1/2 tablespoon extra-virgin olive oil
  • 1/2tablespoon sea salt
  • 1teaspoon freshly ground black pepper
  • 1/2cup Parmigiano-Reggianofreshly grated, plus additional for plating
Zucchini Fettuccine
Tomato Sauce
  1. Prepare a 12″ x 17″ sheet pan with parchment paper. Brush the paper with olive oil.
  2. In a large bowl, add the ground beef, sausage, Parmigiano-Reggiano, onion, garlic, tamari sauce, milk, egg, almond meal, fresh parsley, salt, and pepper.
  3. With clean hands, mix the ingredients. Be careful not to over-handle, as this will result in a tough meatball.
  4. Prepare 3-inch meatballs, again being careful not to over-handle. Place on a parchment-lined baking pan brushed with olive oil. Take care to ensure there is at least an inch or more between meatballs to ensure browning. Utilize a second pan if necessary.
  5. Cover with plastic wrap and place in the refrigerator for 30 minutes to help set the shape. Meanwhile, prepare the tomato sauce.
  6. In a deep pan or pot, add the crushed tomatoes, onion halves, butter, sea salt and black pepper.
  7. Bring to a simmer, then cover.
  8. Gently simmer while meatballs are baking. Adjust salt and pepper to taste. Note: if using Parmigiano-Reggiano to garnish, be careful not to oversalt.
  9. Position a rack in the middle of the oven. Preheat the oven to 400 degrees Fahrenheit.
  10. Remove the meatballs from the refrigerator and place on the center rack of the preheated oven.
  11. Bake for 15 minutes. Gently turn the meatballs with a set of tongs.
  12. Continue baking for another 10-15 minutes or until the meatballs are a deep brown.
  13. Remove meatballs from the oven. Gently place them in simmering tomato sauce, one by one. Re-cover the pan. Let simmer for 30 minutes. Now, prepare the zucchini fettuccine.
  14. Cut the top off of each zucchini. Turn one zucchini on its flat top for stability.
  15. Run a vegetable peeler from end to end, until you see seeds. Turn and repeat on each side. Then repeat on remaining zucchini.
  16. Place the wide zucchini strips into a colander and sprinkle with salt. Let stand for 15-30 minutes. Remove from colander onto paper towels. Pat dry with paper towels to remove excess moisture.
  17. During the last 5 minutes of cook time, heat a large non-stick skillet with olive oil over medium-high heat. Add the zucchini strips.
  18. Sauté for 4-5 minutes, turning the noodles to evenly cook. When the zucchini is soft, stir in parsley, pepper, and chili flakes. Immediately remove from the pan to a bowl or plate so as not to overcook.
  19. Serve meatballs over zucchini fettuccine with tomato sauce, to taste. Top with Parmigiano-Reggiano and reserved parsley.
Recipe Notes

Check ingredients and/or manufacturer’s website to ensure herbs and spices are gluten free.

As noted the meatballs and sauce are freezer friendly. Zucchini noodles won’t freeze well. Make these fresh.

Recipe courtesy of
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