Yes, breakfast sausage can be Paleo, but it depends largely on the ingredients used. The Paleo diet emphasizes foods that were likely to have been eaten during the Paleolithic era, such as lean meats, fish, fruits, vegetables, nuts, and seeds. Traditional breakfast sausage may include sugars, grains, and preservatives that are not permitted in the Paleo diet. However, many brands and homemade recipes use ingredients such as ground pork, herbs, and spices only, which are Paleo-approved.