Italian Sausage, Tomato, and Pesto Soup can be made with macaroni or frozen cauliflower rice, and this is a soup the whole family will enjoy! And I didn’t use much macaroni so this soup isn’t that high in carbs, but see tips below for two lower-carb options.

PIN the Italian Sausage Tomato Soup  to try it later.

Italian Sausage, Tomato, and Pesto Soup close-up photo

For a few years now I’ve been having fun looking through the huge archives of my blog to find a recipe I have the ingredients for, and then updating it, often into an improved version with lower carbs or at least a lower carb option. And that’s what I did with this recipe for Italian Sausage, Tomato, and Pesto Soup!

The original recipe was one I came up with years ago for a family party, and it had twice as much macaroni as the newly updated recipe you see here. This new version with less macaroni has 13 net carbs per serving, but keep reading to see two ideas for making this tasty soup even lower in carbs!

And I switched the fresh basil out for basil pesto that’s easier to have on hand during soup weather, and this soup with pesto was absolutely delicious! So for everyone who needs comfort food while the cold weather approaches, I hope you’ll give this improved recipe a try! And here’s the link to the original version, just in case anyone was a fan.

What ingredients do you need for this recipe?

(This is only a list of ingredients; please scroll down for complete printable recipe. Or if you use the JUMP TO RECIPE link at the top of the page, it will take you directly to the complete recipe with ingredient amounts.)

How to make Italian Sausage, Tomato, and Pesto Soup lower in carbs:

This soup recipe as written with a small amount of macaroni has about 13 carbs in a serving. You can make it even lower in carbs by switching out the macaroni for Fiber Gourmet Light Elbows (affiliate link) or about 10 oz. frozen cauliflower rice. If you use cauliflower rice, this soup will also be gluten-free.

What Italian Sausage did I use for the Italian Sausage Tomato Soup?

For years I made this soup with hot turkey Italian sausage, and then that disappeared from all the stores in my area! But this soup will work well with hot or milk turkey or pork Italian sausage, so use the sausage you prefer.

What gives this sausage, tomato, and pesto soup the Italian flavors?

Italian sausage, garlic, basil, ground fennel, and pesto all make this Italian Sausage Tomato Soup a recipe that’s loaded with Italian flavor. But I think the ground fennel (affiliate link) is especially important here. Please don’t skip that!

Italian Sausage, Tomato, and Pesto Soup process shots collage

How to make Italian Sausage, Tomato, and Pesto Soup:

(This is only a summary of the steps for the recipe; please scroll down for complete printable recipe. Or if you use the JUMP TO RECIPE link at the top of the page, it will take you directly to the complete recipe.)

  1. Combine chicken stock or broth, dried basil, ground fennel, and petite dice tomatoes with juice in a soup pot and let the mixture simmer over low heat while you cook the sausage.
  2. Heat olive oil in heavy frying pan, then squeeze turkey (or pork) Italian sausage out of the links and cook until the sausage is nicely browned; breaking apart with a metal turner.
  3. Add the sausage to the simmering soup pot,
  4. Chop onion and mince garlic. Then add a tiny bit more olive oil to the pan and cook onion about 3-4 minutes. Add minced garlic and cook 1-2 minutes more.
  5. Add the onion and garlic to soup pot.
  6. Deglaze the frying pan with about 1 cup of soup from the pot and scrape off browned bits from the pan, then add that back into the soup
  7. Let this simmer on low heat for 15-20 minutes.
  8. Then add 1/2 cup dry macaroni (or 10 oz. frozen cauliflower rice) to the soup pot and simmer on low for about 15-20 minutes more, or until macaroni or rice is soft.
  9. Then stir in the Basil Pesto and simmer 5 minutes more. 
  10. Serve hot, topped with Parmesan cheese if desired.
  11. This soup freezes well and is great to pull out of the freezer for dinner on a cold winter night!

Italian Sausage, Tomato, and Pesto Soup shown in two bowls with Parmesan on the side.

More Soup with Italian Sausage:

Italian Sausage, Tomato, and Pesto Soup close-up photo
Yield: 8 servings

Italian Sausage, Tomato, and Pesto Soup

Prep Time 10 minutes
Cook Time 50 minutes
Total Time 1 hour

Italian Sausage, Tomato, and Pesto Soup is a family-friendly dinner idea, and this soup can be made with macaroni or cauliflower rice, whichever you prefer.

Ingredients

  • 8 cups homemade chicken stock (see notes)
  • 1 tsp. dried basil
  • 1 tsp. ground fennel
  • two 14.5 oz. cans petite dice tomatoes
  • 5 tsp. olive oil
  • one 19.5 oz. package hot or sweet turkey Italian sausage (see notes)
  • 1 small onion, chopped
  • 1 T minced garlic
  • 1/2 C dry macaroni (see notes)
  • 3 T basil pesto (see notes)

Instructions

  1. Put homemade chicken stock into a large heavy soup pot and start to heat.
  2. Add the dried basil, ground fennel, and 2 cans petite dice tomatoes with juice and let the mixture simmer while you cook the sausage.
  3. Heat 1 T of olive oil in a heavy frying pan.
  4. Squeeze the sausage out of  casings and cook until nicely browned, breaking apart with a metal turner as the sausage cooks.
  5. Add browned sausage to the soup pot.
  6. Add the other 2 tsp. of olive oil to the frying pan, then cook the onions for 3-4 minutes, or until they are starting to soften.
  7. Add the minced garlic and cook 1-2 minutes more.
  8. Add the onion and garlic to the soup pot.
  9. Deglaze the frying pan with about 1 cup of soup from the pot and scrape off browned bits from the pan, then add that back into the soup.
  10. Let this simmer on low heat for 15-20 minutes.
  11. Add the macaroni or frozen cauliflower rice, stir, and continue to simmer the soup for 15-20 minutes more, or until the macaroni or cauliflower rice is soft.
  12. Stir in the basil pesto and cook 5 minutes more.
  13. Serve hot, with freshly grated Parmesan cheese if desired.

Notes

You can also use two 32 oz. cartons of chicken stock or five 14 oz. cans of chicken broth.

I used turkey Italian sausage, but use pork Sausage if you prefer.

I would use my frozenย Basil Pesto with Lemon for this recipe, but I just use my favorite purchased pesto when I don't have any homemade pesto in the freezer.

Nutritional information is calculated with macaroni since that's what is in the photos, but you can use macaroni, or substitute with one 10 oz. package frozen cauliflower rice. Macaroni will be about 5 carbs per serving; cauliflower rice will be 1.5 carbs per serving.

Recipe created by Kalyn for a family party many years ago and updated with lower-carb options in April 2020.

Nutrition Information

Yield

8

Serving Size

1

Amount Per Serving Calories 168Total Fat 9gSaturated Fat 2gTrans Fat 0gUnsaturated Fat 7gCholesterol 12mgSodium 398mgCarbohydrates 13gFiber 0gSugar 4gProtein 8g

Nutrition information is automatically calculated by the Recipe Plug-In I am using. I am not a nutritionist and cannot guarantee 100% accuracy, since many variables affect those calculations.

Did you make this recipe?

Did you make this recipe? Please leave a star rating (under the PRINT button in the recipe) or share a photo of your results on Instagram! THANKS!

Square image for Italian Sausage, Tomato, and Pesto Soup with two bowls, two spoons, and Parmesan in the back.

Low-Carb Diet / Low-Glycemic Diet / South Beach Diet Suggestions:
Soup with macaroni would normally be too high in carbs for a low-carb diet, but I didn’t use much macaroni in this Italian Sausage Tomato Soup. Use the option for cauliflower rice instead of macaroni or use Fiber Gourmet Light Elbows (affiliate link) to make a version that’s even lower in carbs. If made with approved macaroni, this would be approved for phase 2 or 3 of the original South Beach Diet.

Find More Recipes Like This One:
Use Soup Recipes to find more recipes like this one. Use the Recipes by Diet Type photo index pages to find more recipes suitable for a specific eating plan. You might also like to follow Kalynโ€™s Kitchen on Pinterest, on Facebook, on Instagram, on TikTok, or on YouTube to see all the good recipes Iโ€™m sharing there.

Historical Notes for this Recipe:
The original version of Italian Sausage Tomato Soup with Pesto was posted in 2010! The recipe was updated to a more carb-friendly soup, including the option to replace the macaroni with cauliflower rice April 2020. It was last updated with more information in 2025.

Pinterest image of Italian Sausage, Tomato, and Pesto Soup

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