This tuscan macaroni and cheese bake is awesome. How can you go wrong with macaroni covered in cheese sauce, tomatoes and parmesan cheese?

My friend, Dixie, the same one from RaceDay Training, sent me this recipe as a must-try.

Since we were roommates for years and tried out our cooking on each other almost every night, I trust her judgment and knew I would probably love this meal.

I did love it. I mean, we did. It was a slam dunk with my family.

Macaroni and tomato slices baked in a white ceramic dish.

I mean, how can you go wrong with tender macaroni covered in a creamy herb and cheese sauce and topped with tomatoes and golden parmesan cheese? Sign me up.

This would make an excellent Take-In Meal and will definitely be going into our dinner rotation!

Macaroni cheese bake with a scoop taken out in a white ceramic dish.

What To Serve With This:

Divine breadsticks or Cheesy Garlic Bread
Killer green salad (throw together your own or use a variation on this Gourmet Green Salad)
Fresh, seasonal fruit

alt=" "

Tuscan Macaroni and Cheese Bake

5 stars (3 ratings)


  • 12 ounces precooked smoked chicken, or turkey sausage, halved lengthwise and sliced 1/4 inch thick (you can substitute the same amount of Italian sausage – just cook and drain it)
  • 2 cups uncooked elbow macaroni
  • 8 ounces cream cheese, cubed and softened
  • 1 cup sliced olives
  • 1 cup shredded mozzarella cheese
  • 1 ½ tablespoons butter
  • 1 ½ tablespoons flour
  • 1 teaspoon dried sage
  • ¼ teaspoon dried thyme
  • ½ teaspoon salt
  • teaspoon cayenne pepper
  • 1 ½ cups milk
  • 1 medium tomato, sliced thinly
  • ½ cup freshly grated parmesan cheese


  • Cook elbow macaroni according to package directions but undercook the pasta by 1-2 minutes since it will continue baking in the oven.
  • In a large bowl, combine the sausage, cooked pasta, cream cheese, olives, and mozzarella cheese. In a small bowl, mix flour and spices together.
  • In a medium saucepan melt the butter, then whisk in flour and spices. Allow the flour/butter mixture to cook without browning for about 30 seconds while whisking/stirring. Slowly add the milk and stir until slightly thickened, this may take about 5-6 minutes. Stir constantly to prevent scorching on the bottom of the pan. When slightly thickened, pour the milk mixture over pasta mixture and mix well.
  • Pour into an 11X7-inch (or circular) lightly greased casserole dish. Bake covered at 350 degrees for 35 minutes. Remove cover and add tomato slices on top then sprinkle parmesan cheese over and bake uncovered for 10 minutes more. Let sit for 5-10 minutes before serving.
Serving: 1 Serving, Calories: 599kcal, Carbohydrates: 46g, Protein: 27g, Fat: 35g, Saturated Fat: 16g, Cholesterol: 112mg, Sodium: 1551mg, Fiber: 3g, Sugar: 7g

Recipe Source: adapted from Dixie D.