Keto Salisbury Steak Recipe

An easy low carb keto salisbury steak recipe, topped with a rich mushroom gravy! Ready in 30 minutes, this healthy salisbury steak makes a fast and delicious weeknight meal.

Full ingredients + instructions are on the recipe card at the end. Before you scroll or jump down, don’t miss the useful tips in the post!

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Truth be told, my memories of salisbury steak revolve around those terrible TV dinners my dad used to get when I was growing up. But like anything else that they turn into one of those dinners, the homemade version is about eleventy billion times better. And this low carb keto salisbury steak recipe with mushroom and onion gravy is no exception. It may look impressive (and it tastes impressive, let me tell you!), but it takes only 30 minutes to prepare, making it totally weeknight friendly — without having to resort to that processed pre-made stuff.

Serve this healthy salisbury steak over keto mashed cauliflower for a delicious, nutritious meal everyone will love.

Salisbury steak traditionally uses breadcrumbs to hold the meat patties together, and some kind of flour to thicken the sauce, but we need neither in this low carb salisbury steak recipe. We use cream cheese to thicken the gravy, and almond flour makes the perfect keto-friendly breadcrumb swap! Wholesome Yum Almond Flour is blanched and super finely milled, so you won’t even notice the difference.

Keto Salisbury Steak Ingredients

This keto friendly salisbury steak is made with simple ingredients…

For the salisbury steak:

For the gravy:

  • Butter – I like this grass-fed butter, but any kind will do as long as it’s unsalted.
  • Onion – Use white or yellow onions. Sweet onion will also work, but carbs are a bit higher.
  • Cremini mushrooms – You can buy the mushrooms sliced already, or slice them yourself.
  • Beef broth – I use regular beef broth, but if you use a low-sodium version, you may need to season with more salt to taste.
  • Sugar-free ketchup – Same as above.
  • Sea salt & black pepper
  • Cream cheese – Use full fat cream cheese for best flavor and keto benefits.

How To Make Keto Salisbury Steak

This keto salisbury steak recipe with mushroom gravy comes together in a few simple steps.

TIP: Don’t over-mix. If you do, the patties can be tough when they are done.

Ingredients for healthy salisbury steak

  • Cook steaks. Heat olive oil in a large cast iron skillet and cook patties on both sides, until cooked to your liking. Transfer to a plate and cover with foil to keep warm.

Keto salisbury steaks cooking in pan

  • Saute onions and mushrooms. Wipe down the skillet and reduce heat. Add butter and onions, cooking until soft. Add mushrooms and saute until mushrooms have softened and onions are browned.

TIP: You can cook them as shown below, or if you like, cook for longer for more caramelized onions.

Sauteed mushrooms and onions in a skillet

Gravy for healthy salisbury steak recipe

  • Assemble. Return the patties to the pan and spoon gravy over thm. Cook until warm.

Finished low carb salisbury steak recipe

Low Carb Salisbury Steak FAQs

Is salisbury steak keto?

Most salisbury steak recipes will not be keto, because of the flour or breadcrumbs used to bind the patties and in the gravy. This low carb salisbury steak gravy recipe is keto friendly, as we’ve used almond flour to bind the steaks together and cream cheese to thicken the gravy.

How many carbs in salisbury steak?

Average salisbury steak recipes will have about 15+ grams carbohydrates per serving. This low carb salisbury steak recipe has 5.9g net carbs per serving.

Is salisbury steak healthy?

Many salisbury steak recipes are made with white flour and breadcrumbs. This version uses almond flour for a nutritious and tasty variation that adds nutrients and keeps the carbs down.

Can you make the gravy thicker?

Yes, you can. For an extra thick gravy, simmer the broth mixture for longer to reduce it more, before adding the cream cheese. You can also add more cream cheese at the end to make it thicker.

Healthy low carb salisbury steak in a skillet

Storage Instructions

Salisbury steak is best made fresh, but you can do a few things to prep the recipe:

  • Mix up and shape ground beef mixture
  • Dice onions
  • Slice mushrooms

When you’re ready to eat, start recipe at step #3 (cooking patties).

Store any leftovers in the refrigerator for 2-3 days.

Can you freeze keto hamburger steak with gravy?

You can freeze the hamburger steak for 2-3 months, but the gravy may change texture a bit due to the freezing and thawing process.

How to reheat low carb salisbury steak:

Reheat the chopped steaks in a hot skillet or microwave, until heated through.

2 plates of low carb salisbury steak with cauliflower mash and green beans

What To Serve With Salisbury Steak

All this low carb salisbury steak and gravy needs is some simple sides:

  • Cast Iron Skillet – All of the cooking for this healthy salisbury steak with mushrooms can happen in this one pan. The enameled interior reduces sticking and it’s beautiful enough to serve.

Reader Favorite Recipes

The recipe card is below! Readers that made this also viewed these recipes:

Keto Salisbury Steak Recipe

An easy low carb keto salisbury steak recipe, topped with a rich mushroom gravy! Ready in 30 minutes, this healthy salisbury steak makes a fast and delicious weeknight meal.

Prep Time 5 minutes

Cook Time 25 minutes

Total Time 30 minutes

Servings 4 servings


Click underlined ingredients to see where to get them. Please turn Safari reader mode OFF to view ingredients.

Keto Flours


Get RECIPE TIPS in the post above, nutrition info + recipe notes below!

Click on the times in the instructions below to start a kitchen timer while you cook.

  1. In a large bowl, mix ground beef, almond flour, sugar-free ketchup, Dijon mustard, sea salt, and black pepper until combined. Do not overmix.

  2. Using your hands, form four 1/2-inch-thick oval shaped patties.

  3. Heat the olive oil in a large cast iron skillet over medium-high heat. Add the patties, cover, and cook for 4-5 minutes. Flip and cook for 4-5 minutes more, until cooked to your liking. Remove patties to a plate and cover with foil to keep warm.

  4. Wipe down the skillet and reduce heat to medium. Add the butter and onions, and sauté for 3-4 minutes, until soft but not browned.

  5. Add sliced mushrooms and sauté for about 5 minutes, until mushrooms are soft and onions have browned.

  6. Add the beef broth, sugar-free ketchup, sea salt, and pepper. Bring to a boil, then reduce heat and simmer for 5-7 minutes.

  7. Reduce heat to low. Stir in the cream cheese, until the gravy is smooth and has thickened slightly.

  8. Return the patties to the pan and spoon gravy over them. Cook for 1-2 minutes, until the patties are warm.

Recipe Notes

Serving size: 1 patty with gravy

Nutrition Information Per Serving

Nutrition Facts

Amount per serving. Serving size in recipe notes above.

Calories 530

Fat 39.8g

Protein 36.3g

Total Carbs 7.2g

Net Carbs 5.9g

Fiber 1.3g

Sugar 2.9g

Where does nutrition info come from? Nutrition facts are provided as a courtesy, sourced from the USDA Food Database. You can find individual ingredient carb counts we use in the Low Carb & Keto Food List.

Net carb count excludes fiber, erythritol, and allulose, because these do not affect blood sugar in most people. (Learn about net carbs here.) We try to be accurate, but feel free to make your own calculations.

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