Ham is a processed meat product typically high in sodium and synthetic additives, including sodium nitrite (NaNO₂), which enhances flavor, color, texture, and shelf life. However, NaNO₂ is classified by the World Health Organization (WHO) as a potential carcinogen, leading to a growing interest in “clean label” alternatives that forgo synthetic additives in favor of natural ingredients. Beetroot, rich in nitrates that can be converted into nitrites through starter cultures, has emerged as a promising alternative to sodium nitrite. In addition to its nitrate content, beetroot offers antioxidant properties and acts as a natural colorant. The antioxidant capacity of beetroot extracts can control the nitrite levels along digestion. This study evaluated the effects of replacing NaNO₂ in cooked ham with freeze-dried beetroot extract, focusing on changes in N-nitroso compound markers, oxidation, and antioxidant activity throughout simulated in vitro digestion. Samples were divided into five treatments: a control with sodium NaNO₂ and sodium erythorbate (COP), a negative control with sodium erythorbate only (CON), and three beetroot treatments - AP (beetroot extract only), APC (beetroot extract with a starter culture) and APCE (beetroot extract, starter culture, and sodium erythorbate). Results indicated a significant reduction in residual nitrite during digestion, most notably in the COP treatment. The beetroot treatment (AP) showed an increase in TBARS content during the gastric phase, it also demonstrated reduced lipid and protein oxidation in the subsequent phase. Antioxidant capacity, assessed using ABTS, FRAP, and ORAC assays, varied between treatments and phases, with beetroot-containing samples showing enhanced antioxidant capacity throughout digestion. In conclusion, replacing NaNO₂ with freeze-dried beetroot extract in cooked ham offers a natural and effective alternative that supports antioxidant benefits, reduces oxidation, and lowers residual nitrite levels during digestion.