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Low Carb Creamy Pesto Alfredo Sauce 

If you love the comforting creaminess of Alfredo pasta and the fresh, herby zing of basil pesto… you’re going to adore this simple sauce recipe.

This creamy pesto Alfredo sauce is smooth, flavorful, and packed with rich cheesy goodness. And yes — it’s completely low carb, keto-friendly, and fits perfectly in a THM S setting (depending on what pasta or pasta alternative you use).

That’s right, you can enjoy all the comforting flavors of pasta night without going off-plan.

It’s perfect over grilled chicken, steamed veggies, or even low-carb noodles. And the best part? It comes together in just minutes on the stovetop — no fancy equipment required.

Honestly, homemade alfredo sauce is one of my family's favorites! 

What is Pesto Alfredo Sauce for pasta?

This recipe is exactly what it sounds like — a cozy blend of creamy Alfredo sauce and flavorful basil pesto. Think of it as your favorite fettuccine Alfredo, but with a burst of fresh herb flavor that takes everything up a notch.

The creamy base comes from real-food ingredients like butter, cream, and parmesan cheese, while the pesto brings in garlic and fresh basil.

Together, they make a silky, flavor-packed sauce that’s just as good (if not better!) than anything you’d find at a restaurant.

A Low Carb Option That Doesn’t Feel Like “Diet Food”

When you’re following a low carb or THM lifestyle, it can sometimes feel like you have to miss out on the fun — especially when it comes to rich pasta dishes.

But with this creamy pesto Alfredo, you get to enjoy all the flavor, without the carbs.

Because we’re using simple, wholesome ingredients with no starches or fillers, this sauce stays firmly in S territory. It’s also completely gluten-free, making it a great option for anyone avoiding grains.

How to Make Creamy Pesto Alfredo Sauce

This recipe is as easy as it gets — truly.

The first step is to melt the butter in a skillet, then gently sauté some garlic until fragrant (just a minute or so). Then you’ll pour in the heavy cream and bring it to a low simmer.

Once the cream is warm, you’ll slowly whisk in the parmesan cheese until it melts into a rich, velvety sauce. That’s the Alfredo part!

To finish, you’ll stir in a generous spoonful of basil pesto — and just like that, you’ve created a sauce that’s creamy, dreamy, and absolutely bursting with flavor.

Season with a pinch of salt and pepper to taste, and you’re ready to serve.

What Should I Serve With Pesto Pasta?

If you’re not doing traditional pasta (which is off-plan for THM and low carb), you still have so many delicious options!

This sauce is super versatile, and works with all kinds of low-carb main dishes and veggies. There are many pasta alternatives available, too!

Here are some of my favorite ways to serve it:

Over zoodles (zucchini noodles)

On a bed of spaghetti squash instead of pasta

Tossed with roasted broccoli or cauliflower

Poured over grilled chicken

Spooned onto salmon or shrimp

Mixed with low-carb konjac noodles (if you tolerate them)

It even makes a great dipping sauce for grilled veggies or low-carb breadsticks!

Can I Use a Jar of Store-Bought Pesto Sauce?

Yes, absolutely! You may love making your own homemade pesto, but let’s be honest — some days you just need a shortcut. A good quality jar of pesto from the store will work beautifully here.

Just check the ingredients list to make sure it doesn’t contain any added sugars or inflammatory oils. Look for options made with olive oil, basil, parmesan, and garlic.

Of course, if you have fresh basil on hand, it’s easy to blend up a quick batch of homemade pesto in just a few minutes. Either way, this sauce will taste amazing.

Tips for a Perfect Basil Pesto Alfredo Sauce

Here are a few simple tips to help your sauce turn out just right every time:

Use freshly grated parmesan cheese for the smoothest, creamiest texture.

Let the cream simmer, not boil — gentle heat is key!

If the sauce gets too thick, add a splash of heavy cream or unsweetened almond milk.

If it’s too thin, let it simmer a few more minutes to thicken.

Stir the pesto in last, so it keeps that bright, fresh flavor.

If you’ve made homemade Alfredo before, this will feel very familiar — but with a delicious twist.

Storing and Reheating Tips for this Pasta Sauce

This sauce stores well in the fridge for a few days, so it’s great for meal prep.

To reheat, just warm it gently in a skillet over low heat. Add a splash of cream if needed to loosen the sauce and make it smooth again. (Microwaving can work in a pinch, but stovetop is best for texture.)

Delicious Ways to Make Pesto Alfredo a Meal

Here are a few ideas to help turn this pesto Alfredo into a full, satisfying dinner:

Grilled chicken and zoodles topped with pesto Alfredo 

Roasted broccoli and sautéed mushrooms smothered in sauce

Baked salmon with pesto Alfredo drizzled over the top

Low-carb Alfredo chicken bake with mozzarella on top

Roasted spaghetti squash boats filled with pesto Alfredo and veggies

You really can’t go wrong here — this sauce makes just about everything taste better!

This low carb creamy pesto Alfredo sauce is a cozy, comforting recipe you’ll want to make again and again. It’s rich, flavorful, and perfect for nights when you need something fast but delicious.

And best of all? It’s 100% on-plan — no guilt, no carbs, just real food that tastes amazing.

More Low-Carb Alfredo Recipes

Alfredo Chicken Casserole

Keto Shrimp Alfredo

Low-Carb Chicken Alfredo Pizza

Broccoli Alfredo Soup with Sausage

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