Tuscan Macaroni and Cheese Bake

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. 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!

Tuscan Macaroni and Cheese Bake

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

Tuscan Macaroni and Cheese Bake

Yield: Serves 4 (I doubled the recipe and it easily served three adults and three children)

Tuscan Macaroni and Cheese Bake


  • 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 1/2 tablespoons butter
  • 1 1/2 tablespoons flour
  • 1 teaspoon dried sage
  • ¼ teaspoon dried thyme
  • ½ teaspoon salt
  • 1/8 teaspoon cayenne pepper (don’t be afraid of this! It won’t make it spicy, I promise)
  • 1 ½ cups milk
  • 1 tomato, sliced thinly
  • ½ cup freshly grated parmesan cheese


  1. 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.
  2. 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.
  3. 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.

Recipe Source: adapted from Dixie D.

28 Responses to Tuscan Macaroni and Cheese Bake

  1. Nicole says:

    Can you prep this the night before and then just bake it the next day?

  2. Rachel says:

    we loved!! Made in 2 loaf pans- baked and ate one the first night (Tons for our 2 adults and 2 young kids ). The second half of the recipe, prepared in the second loaf pan-but did not bake the last 2 steps. Covered with plastic wrap and foil- and froze. We are now 2 weeks later, and I defrosted it over night in the fridge and just baked as normal- FABULOUS!! Loved it the first time- but esp the second time as didn’t have to do any work for fab dinner!

  3. Whitney says:

    Mel, I just wanted you to know that since discovering this recipe last year on your site, we have had this meal at least 15 times. No joke!!! It is such a favorite at our house now. We had it again just last night and it was wonderful. I love all of your recipes that I’ve tried. Please keep em coming!

  4. Steph says:

    oh yum! yum yum yum! this was SO GOOD! My husband and I just gobbled it right up. This will definitely be a family favorite. Delicious comfort food! I used 1/3 less fat cream cheese and it worked perfectly. Can anyone tell me if fat free cream cheese would substitute well in a recipe like this?

    • Mel says:

      Steph – glad you loved this one! I would hesitate to use fat free cream cheese. When I’ve used it in recipes like this, the texture becomes grainy and tastes a little “off.” I think it needs a little fat to help bind it together.

  5. Lori says:

    Yum! I made this with cubed chicken instead of the sausage because that is what I had on hand. Big hit with the whole family! Thanks

  6. Melanie says:

    Anonymous – glad you liked this pasta dish! Thanks for letting me know.

  7. Anonymous says:

    This dish was out of this world delicious. Every bite had a different taste. Will make it again, and again…..

    Thanks for the great recipe.

  8. Melanie says:

    JoAnn – glad you liked this. I’m almost sure mine looks more yellow because of the lighting for the picture. My sauce was also very white.

    Lori – thanks for your comment! I’m glad you have liked so many recipes. Thanks!

  9. Lori says:

    This was delish! Mine also came out white. Thanks again for another great recipe. I’ve made about 20 recipes from your blog and that is a lot considering I just stumbled upon your blog a couple of months ago! I’ve made more recipes from your blog than any other. We must have similiar taste buds 🙂

  10. JoAnn says:

    Hey Melanie–

    I made it, we loved it. But why does it look so yellow in your pic? Mine came out very white, and I don’t think I did anything wrong…

  11. Melanie says:

    Anonymous – It definitely tastes better the day of making it but reheats pretty well over low heat (or in the microwave on low heat).

  12. Anonymous says:

    Hi Melanie, does this dish taste good the next day? Being that its probably not a freezable dish, I would at least like to have some for lunch the next day!

  13. Melanie says:

    Anonymous – I have not tried freezing this dish before adding tomatoes and baking. One reason I would be hesitant to do so is because the sauce is milk based and I’m not sure if freezing would affect the texture. However, let me know if you try it!

  14. Melanie says:

    Jared and Davian – thanks for letting me know you liked the soup and rolls! I love to know when meals are a raving success. Thank you!

  15. Jared and Davian says:

    I just made the Creamy Chicken and Wild Rice Soup and Buttermilk Cloverleaf Rolls for dinner…. AMAZINGLY DELICIOUS!! Thank you for sharing *TASTY* recipes for my family to enjoy! THANK YOU!!

  16. FoodFitnessFreshair says:

    I love homemade mac…it’s so much better than anything store bought, so if I’m going to indulge, I’d much rather make it myself! Recipe looks great.

  17. teresa says:

    oh this is a crazy family pleaser, love it!

  18. Barbara says:

    I love this twist on the old favorite! Add some sage, thyme and sausage and you have a whole new dish. Great!

  19. figtree says:

    This would be a HUGE hit in my hse! Ill try it this Sunday.

  20. Jelli Bean says:

    This looks really delicious. I know my family would love it, especially topped with loads of cheese.

  21. grace says:

    i tend to enjoy anything having to do with tuscan flavors and i tend to enjoy anything called macaroni and cheese. i have a hunch i’d like this. 🙂

  22. Marisa says:

    That sounds great and also really easy. I think my family would love it too–what kid wouldn’t love a variation on a favorite mac & cheese???

  23. Jessie says:

    Oh my that looks so yummy!! I am definitely going to have to try it out. Same with the pumpkin Muffins. Nothing is better than Pumpkin and cream cheese together. Thanks for sharing the recipes!!!

  24. !♣!F®om †he In§ide ou‡!♣! says:

    Oh wow, that looks yummy!! 🙂 We’ll definitely be trying this, as my daughter asks for macaroni and cheese almost every day…which is on the ‘recommended’ toddler menu, along with PB&J and chicken nuggets….. 😉 At least I’d be able to get her to eat some meat and tomatoes too…lol… 🙂

    *I’m assuming the olives are black ones? Or what about a mix of black and green?

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