North Macedonian answer to pizza is called pastrmajlija, a rustic bread pie consisting of dough topped with cubed or sliced meat (usually pork and cured mutton), with variations that might include eggs, hot peppers, and other ingredients. Pastrmajlija is often baked in traditional ovens at very high temperature.

This oval-shaped delicacy is sometimes accompanied by hot pickled peppers, and it is especially popular during the colder, winter months. The name of the dish is derived from the word pastrma, meaning salted and dried sheep or lamb meat.