Prepare a large skillet for cooking the keto salisbury steak. If you want to use olive oil for cooking, add that as well. But, do not turn the stove on yet.
Whisk the egg, worcestershire sauce, and ketchup in a small bowl. Set aside.
Now add thawed ground beef, almond flour, black pepper, sea salt, Italian seasoning, and fresh minced onion to a medium bowl. Use a sturdy spoon to stir the mixture well. Depending on the texture of the ground beef, you may want to just use your hands.
Once the dry ingredients have been combined well, add the egg mixture.
And lastly, shape the meat mixture into four salisbury steaks.
Preheat the skillet on medium heat for a minute or two and then add all four steaks.
Cover the skillet with a lid. Flip the salisbury steaks when necessary to cook the opposite side.
Once the keto salisbury steak is finished cooking, remove them from the skillet and set aside.