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Bring a large pot of generously salted water to a rolling boil. Add the rigatoni pasta and cook according to package directions until al dente. Reserve 1 cup of pasta water before draining the pasta.

While the pasta is cooking, heat the olive oil in a large skillet or Dutch oven over medium-high heat. Add the Italian sausage, breaking it up with a spoon, and cook until browned and cooked through, about 5-7 minutes. Drain any excess fat.

Reduce the heat to medium. Add the diced yellow onion to the skillet with the sausage and cook until softened, about 3-4 minutes.

Stir in the minced garlic and red pepper flakes (if using) and cook for another minute until fragrant.

Pour in the crushed tomatoes, kosher salt, and black pepper. Bring the sauce to a simmer, then reduce heat to low, cover, and let it cook for at least 10 minutes to allow the flavors to meld. Stir occasionally.

Stir in the heavy cream and grated Parmesan cheese until well combined and the sauce is creamy. Add the chopped fresh basil.

Add the drained rigatoni pasta to the sauce. Toss to coat the pasta evenly. If the sauce is too thick, add a splash or two of the reserved pasta water until it reaches your desired consistency.

Serve immediately, garnished with extra grated Parmesan cheese and fresh basil, if desired.


Bring a large pot of generously salted water to a rolling boil. Add the rigatoni pasta and cook according to package directions until al dente. Reserve 1 cup of pasta water before draining the pasta.

While the pasta is cooking, heat the olive oil in a large skillet or Dutch oven over medium-high heat. Add the Italian sausage, breaking it up with a spoon, and cook until browned and cooked through, about 5-7 minutes. Drain any excess fat.

Reduce the heat to medium. Add the diced yellow onion to the skillet with the sausage and cook until softened, about 3-4 minutes.

Stir in the minced garlic and red pepper flakes (if using) and cook for another minute until fragrant.

Pour in the crushed tomatoes, kosher salt, and black pepper. Bring the sauce to a simmer, then reduce heat to low, cover, and let it cook for at least 10 minutes to allow the flavors to meld. Stir occasionally.

Stir in the heavy cream and grated Parmesan cheese until well combined and the sauce is creamy. Add the chopped fresh basil.

Add the drained rigatoni pasta to the sauce. Toss to coat the pasta evenly. If the sauce is too thick, add a splash or two of the reserved pasta water until it reaches your desired consistency.

Serve immediately, garnished with extra grated Parmesan cheese and fresh basil, if desired.
