Overhead shot of Turkey Florentine Meatballs with Pesto Spaghetti Squash in a bowl

Turkey Florentine Meatballs with Pesto Spaghetti Squash

  • Author: Cassie Johnston
  • Cook Time: 1 hour
  • Total Time: 1 hour
  • Yield: 4 servings 1x


These Turkey Florentine Meatballs with Pesto Spaghetti Squash are grain-free, dairy-free, and nut-free (yes, even the pesto), but they are definitely not flavor-free! You’ll love the combination of the creamy, silky spaghetti squash noodles with the hearty, garlicky meatballs.

Inspired by: Amy Myers, MD

Gluten-free, Paleo, AIP, Dairy-Free, Grain-Free



  • Avocado oil cooking spray
  • 1 large spaghetti squash
  • Coarse sea salt
  • 1 tablespoon coconut oil or avocado oil
  • 8 cloves garlic, roughly chopped
  • 8 cups loosely packed baby greens (I like to do half baby spinach, half baby kale)
  • 1 cup well-packed fresh basil leaves
  • Juice of 1 lemon (about 1/4 cup)
  • 1 teaspoon salt, divided, plus more to taste
  • 1/2 ripe avocado
  • 1/3 cup extra virgin olive oil
  • 1 small onion, roughly chopped (about 1/3 cup)
  • 2 teaspoons dried oregano
  • 1 pound ground turkey


  1. Preheat oven to 400°. Spray two baking sheets with cooking spray and set aside.
  2. Cut 1/2” off each end of the spaghetti squash, then slice the spaghetti squash in half crosswise, then again to make four thick rings (see my friend Beth’s post for why you should do this to get the best spaghetti squash noodles).
  3. Remove the seeds and other inside goo. Then place the rings onto a clean kitchen towel. Salt the rings liberally with coarse sea salt. Let rest for 15 minutes while the moisture is drawn out. Using a clean kitchen towel, pat the squash dry, and brush off any extra salt.
  4. Place rings on one of the prepared baking sheets. Roast in preheated oven for 25-30 minutes, or until the squash is very tender. Remove from oven and let cool to the touch, then remove the noodles from the squash peel and “fluff” with a fork. Cover with foil or a kitchen towel to keep warm, and set aside.
  5. While squash is roasting, heat the coconut or avocado oil in a large skillet. Add in the garlic, and cook until just fragrant, about 3 minutes. Add in the baby spinach and baby kale, tossing to coat with the garlic. Cook until just wilted, about 3 minutes. Remove from heat.
  6. In a food processor, add half of the spinach and kale mixture (reserving half), the basil, lemon juice, 1/2 teaspoon of salt, and avocado. Pulse until well blended and no large chunks of greens remain. You may need to stop and scrape the sides of the food processor a few times.
  7. While the food processor is running on low, stream in the olive oil slowly until completely combined. Scoop out the pesto and store in the fridge until ready to serve.
  8. Place the food processor bowl back on (no need to clean it), and add the remaining spinach and kale mixture, the onion, the oregano, and 1/2 teaspoon salt. Pulse until everything is well-combined.
  9. In a medium bowl, add the spinach and kale mixture from the food processor to the ground turkey. Stir until well-combined.
  10. Form mixture into 1 1/2” meatballs (you should get about 24 of ‘em) and place them on a baking sheet. Place in preheated oven, and bake for 12-15 minutes, flipping halfway through cooking time. Meatballs should register 160°F on a thermometer when finished.
  11. To serve: Toss the hot spaghetti squash noodles with the pesto sauce, and then top with meatballs. If you need to thin the pesto sauce, you can add a little bit of hot broth or hot water to it, and then toss in the noodles.


I know you are tempted to skip salting the spaghetti squash. I see you. You say, “it can’t matter that much!” It totally does. Salting brings out a ton of moisture, which is the difference between long, beautiful spaghetti squash noodles and mushy goo of squash. SALT IT.

If you’re looking to bump up the nutrient-density of the meatballs, you can add one chicken liver to the food processor before pulsing—the garlic and herbs in the meatballs cover any lingering liver-y flavor—even my three-year-old eats these meatballs!

Ground turkey can be tricky. The fresh stuff from the meat counter tends to work best for this recipe because it doesn’t have as much water content as the frozen stuff. If you do use frozen, you’ll want to add 2-4 tablespoons of a thickening flour (such as cassava, arrowroot, or coconut) in order to be able to form the meatballs properly. Or, you can just divvy out the meatballs using a 1 1/2 tablespoon cookie scoop—it’s my favorite way to make meatballs anyway! No yucky hands.

  • Category: Entrees
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