Paleo Vodka Sauce Over Fettuccines

Paleo Vodka Sauce Over Fettuccines

With the cold weather, I'm really on a kick putting together some of my favorite comfort foods! Vodka sauce was always one of my favorite dishes pre-healthy eating so I was on a mission last night to recreate my childhood favorite with the help of my amazing sister Venita (she's an AMAZING cook)! The awesome part of this recipe is that it's super versatile. You can use the sauce over Cappello's noodles (my favorite way to have it!), put it over spaghetti squash, or you can even combine with the veggie (or protein) of your choice to make an easy casserole in the oven (I've used the sauce with cauliflower florets as well as shredded chicken that you can make ahead and pop in the oven at 400 until bubbly). This is also a great weeknight dish since it takes only 30 minutes and two pans to put together.

Also, two suggestions that make this dish really stand out -- first, get a high quality pancetta. We have this fantastic Italian market near us in the North Fork that slices the pancetta to order. I ask for medium slices and since John likes every pasta dish "extra meaty" I always add a bit more meat. Lastly, like the Amatriciana sauce that I make, this really does get better the next day. So if you're in meal prep mode, then this is a perfect sauce to make ahead and put on top of whatever your heart contents. 

I'm already planning my next night to make this!

Prep time: 15 minutes
Cook time: 30 minutes
Serves: ~8


  • 6 tbsp of ghee
  • 10 garlic cloves, minced
  • 2-3 shallots, minced
  • 2 28 oz cans of San Marzano tomatoes crushed in a bowl with your hands
  • 1 pound of high quality pancetta (medium/thick sliced)
  • 1/2 cup of vodka
  • Red pepper flakes to taste
  • Salt and pepper to taste
  • 1 cup of coconut cream (*you can use a 13.5 oz can of regular coconut milk, but I like to use coconut cream since it makes the sauce thicker)
  • 1/2 cup of parmesan cheese (optional)
  • 3 packages of Cappello's fettuccine or 2 spaghetti squash
  • Fresh basil for garnish


  1. Melt the ghee in a large sauce pan over medium heat
  2. Add the pancetta and cook until crisp
  3. Remove pancetta with a slotted spoon and reserve on the side
  4. Pour off all but 4 tbsp of the remaining oil from the pan (you can save the leftover oil to make eggs!)
  5. Add the garlic and cook until fragrant (~1-2 minutes). Continue to cook over medium heat
  6. Add the shallots and cook another 5 minutes
  7. Stir in the vodka, crushed tomatoes, salt and red pepper
  8. Bring to a boil and then reduce to a simmer until the sauce is thickened (~10-15 minutes or longer if you have the time)
  9. Stir in the coconut cream and cook another 5 minutes
  10. Turn off the heat and add the reserved pancetta, cheese (if using) and noodle of choice
  11. Garnish with generous amount of basil
  12. Enjoy!