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Preheat the oven to 375 degrees F (190 degrees C). Lightly grease a sheet pan.
Combine turkey, bread crumbs, pesto, Pecorino Romano cheese, egg, salt, and pepper in a mixing bowl and mix with your hands until well combined.
Roll mixture into small, walnut-sized meatballs. Place onto the prepared pan.
Bake in the preheated oven until no longer pink in the centers, 20 to 25 minutes.