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Overhead photo of Supreme Pizza Mac and Cheese in an oval dish
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5 from 12 votes

Supreme Pizza Mac and Cheese

This Supreme Pizza Mac and Cheese is totally drool worthy folks! It's loaded with all the ingredients on a supreme pizza pie and SUPER tasty!

Prep Time30 mins
Cook Time30 mins
Total Time1 hr
Course: Main Course
Cuisine: Italian
Keyword: Pasta, Pizza
Servings: 12 servings
Calories: 670kcal
Author: MaryAnn Dwyer


  • 16 oz. pasta shells, you can also use elbows
  • 8 oz. sweet Italian sausage, removed from casings
  • 1 cup red onion, chopped
  • 1 cup green bell pepper, chopped
  • 1 cup red bell pepper, chopped
  • 3 garlic cloves, minced
  • 6 Tbsp. butter
  • 1/3 cup all-purpose flour
  • 3 cups whole milk
  • 1 cup heavy whipping cream
  • 1 1/2 tsp. Italian seasoning
  • 1 1/2 tsp. kosher salt
  • 1/2 tsp. freshly ground black pepper
  • 2 cups marinara sauce
  • 4 cups Fontina cheese, freshly grated
  • 2 cups mozzarella cheese, freshly grated
  • 1/2 cup parmesan cheese, grated
  • 2 oz. pepperoni slices, about 25 slices from 3 oz. package
  • fresh basil, chopped, for sprinkling, if desired


  • Preheat oven to 375 degrees. Spray a 13x9 pan with nonstick cooking spray. Set aside. Prepare the macaroni al dente according to directions on package. Drain and set aside.

  • In a large skillet over medium-high heat, cook Italian sausage until no longer ponk, breaking up with a wooden spoon, about 4 minutes. Add red onion and peppers and cook for 5 minutes. Add garlic and continue to cook one more minute. Remove from heat and set aside.
  • Melt 6 Tbsp. butter over medium heat in a large dutch oven. Whisk in flour and cook for one minute. Slowly whisk in milk, cream, Italian seasoning, salt and pepper. Stirring constantly, continue to cook for 6 minutes until nice and thick. Add the marinara sauce, 3 1/2 cups fontina cheese and 2 cups mozzarella cheeses and mix until the cheese is melted and the sauce is smooth. Add the cooled pasta, the Italian sausage and veggies and the pepperoni slices.
  • Pour into the prepared dish and sprinkle with the remaining 1/2 cup fontina and grated parmesan cheeses. Bake until bubbly and nice and golden browned, about 30 minutes. Sprinkle with fresh chopped basil, if desired. Serve immediately.


Calories: 670kcal | Carbohydrates: 41g | Protein: 29g | Fat: 43g | Saturated Fat: 24g | Cholesterol: 138mg | Sodium: 1297mg | Potassium: 505mg | Fiber: 3g | Sugar: 8g | Vitamin A: 1761IU | Vitamin C: 30mg | Calcium: 501mg | Iron: 2mg