This Paleo Italian Meatballs and Sauce recipe cooks for three hours and results in a rich tomato sauce full of flavorful healthy meatballs.

Do you ever get inspired to eat something after watching an actor eat that food in a movie or TV Show? This happens to me ALL the time.

For example, when I used to watch the Gilmore Girls, I always wanted coffee and pizza. And most recently, I have been watching the Sopranos and thus have been wanting Italian food all the time, or more specifically, “spaghetti and gravy”. MAN does watching that show make me want to eat Italian food… so much so that I ended up making this Paleo Italian Meatballs and Sauce recipe. 🙂

Paleo Italian Meatballs and Sauce (GF)| Perchance to Cook,

Normally, I bake my meatballs, but I had always wanted to try making them in sauce.

So, I did some research and found these two recipes: Authentic Italian Tomato Sauce and Authentic Italian Meatballs.

These recipes have rave reviews, but what really got me to try them was that the tomato sauce recipe called for cloves, something I have never used in a tomato sauce recipe before, and also that it was a recipe from a small town in Italy. Sold.

So, I made both recipes. And I anxiously waited…3 hours.. wondering if the meatballs would be too soggy or if I would even like them cooked this way.

Paleo Italian Meatballs and Sauce (GF)| Perchance to Cook,

And let me tell you. Making them this way is unbelievable…all of the flavors seep into each other and become so rich and full of depth…

I totally think all meatballs should be cooked this way, in a homemade tomato sauce, simmering for 3 hours.

Those recipes (and the Sopranos haha) inspired me to make a Paleo version, with some of my own flavor tweaks…

Which brings us to this Paleo Italian Meatballs and Sauce recipe!

Paleo Italian Meatballs and Sauce (GF)| Perchance to Cook,

It’s really quite simple, all you need is time…so if you know you’ll be home one afternoon, do yourself a favor and make these…the smell of the rich tomato sauce in your house, and the tasty tender meatballs that follow make it worth it!

To start, mix all the meatball ingredients together (ground beef, eggs, coconut or almond milk, almond flour, salt, dried parsely, garlic powder, and ground pepper) and then set the mixture aside.


Then, simmer the onion, garlic, and red pepper flakes together until fragrant.


Next, add the crushed tomatoes, strained tomatoes, cloves, dried basil, salt, paprika, oregano, ground black pepper, and honey to the pot.

Paleo Italian Meatballs and Sauce (GF)| Perchance to Cook,

Then, roll the meatballs into golf sized balls and put them into the tomato sauce pot.

Sprinkle with a little extra basil. 🙂

Paleo Italian Meatballs and Sauce (GF)| Perchance to Cook,

Lastly, let everything simmer for 3 hours…the smell in your house will be fabulous, making it difficult to actually wait to get your hands on these delicious tender meatballs.

And the sauce for that matter. I could drink it!  I guess my mom was right when she said, the longer you cook an Italian sauce the better.

Paleo Italian Meatballs and Sauce (GF)| Perchance to Cook,

This Paleo Italian Meatballs and Sauce recipe is great on zoodles, GF pasta, or alone.

One thing worth noting is that if you do use coconut milk here, you will be able to taste it. Since the meatballs cook for so long, the flavors really cook into them.

I personally liked it, and it isn’t overwhelming, but if you don’t love coconut, I’d use almond milk.

Paleo Italian Meatballs and Sauce (GF)| Perchance to Cook,
Paleo Italian Meatballs and Sauce (GF)| Perchance to Cook,

Paleo Italian Meatballs and Sauce (GF)

5 from 1 vote
Prep Time 10 mins
Cook Time 3 hrs
Total Time 3 hrs 10 mins
Course Main Course
Cuisine Italian
Servings 20
Calories 123 kcal


Meatball Ingredients:

  • 1 lb lean ground beef
  • 2 eggs
  • 1/4 cup coconut milk or almond milk ( I used Golden Star coconut milk, but if you don’t want any coconut flavor, use almond milk)
  • ¾ cup almond flour
  • 1/2 tsp salt
  • 1 Tbs dried parsley
  • 1 tsp garlic powder
  • 1/2 tsp ground black pepper

Tomato Sauce Ingredients:

  • a scant 1/4 cup olive oil
  • 2 Tbs diced garlic (this was 5 of cloves for me)
  • 3/4 cup diced yellow onion (this was 1 smalll onion for me)
  • 1/8 tsp crushed red pepper/red pepper flakes
  • 4 cups strained tomatoes (I always use Pomi)
  • 3 cups chopped tomatoes (again, I always use Pomi)
  • 6 whole cloves
  • 1 1/2 tsp dried basil
  • 1 tsp salt
  • ¼ tsp paprika
  • ½ tsp dried oregano
  • ½ tsp ground black pepper
  • 2 Tbs honey


  • Mix all of the meatball ingredients together in a large bowl ( 1lb lean ground beef lean, 2 eggs, 1⁄4 cup coconut milk or almond milk, ¾ cup almond flour, 1/2 tsp salt, 1 Tbs dried parsley, 1 tsp garlic powder, 1/2 tsp ground black pepper). Mix either by hand or with a fork. Set the mixture aside.
  • Then, put a scant 1/4 cup of olive oil into a large pot, and sauté 2 Tbs diced garlic, 3/4 cup of diced onion, and 1/8 tsp of crushed red pepper flakes together for 2-3 min over medium-high heat.
  • Reduce the heat to medium, and add the 4 cups of strained tomatoes and and 3 cups of crushed tomatoes to the pot and mix. Add the 6 cloves, 1 1/2 tsp dried basil, 1 tsp salt, ¼ tsp paprika, ½ tsp dried oregano, 1/4-1/2 tsp of fresh ground pepper, and 2 Tbs honey to the pot and mix. Lower the heat to a simmer.
  • Then, roll golf ball sized meatballs out of the meatball mixture and put them into the sauce in the large pan. Let the sauce simmer for 3 hours.
  • This makes approximately 20 meatballs total.


Calories: 123kcalCarbohydrates: 9gProtein: 8gFat: 7gSaturated Fat: 2gPolyunsaturated Fat: 1gMonounsaturated Fat: 3gTrans Fat: 0.1gCholesterol: 30mgSodium: 311mgPotassium: 320mgFiber: 2gSugar: 5gVitamin A: 188IUVitamin C: 9mgCalcium: 49mgIron: 2mg
Tried this recipe?Let us know how it was!