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

While the pasta cooks, 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 chopped yellow onion to the skillet with the sausage and cook until softened, about 3-5 minutes.

Stir in the minced garlic and red pepper flakes (if using) and cook for 1 minute more until fragrant.

Pour in the crushed tomatoes, 1 tablespoon of kosher salt, and black pepper. Bring to a simmer, then reduce heat to low, cover, and let it cook for 10 minutes, stirring occasionally.

Stir in the heavy cream and grated Parmesan cheese until well combined and heated through.

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

Stir in the fresh chopped basil. Taste and adjust seasoning if needed.

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


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

While the pasta cooks, 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 chopped yellow onion to the skillet with the sausage and cook until softened, about 3-5 minutes.

Stir in the minced garlic and red pepper flakes (if using) and cook for 1 minute more until fragrant.

Pour in the crushed tomatoes, 1 tablespoon of kosher salt, and black pepper. Bring to a simmer, then reduce heat to low, cover, and let it cook for 10 minutes, stirring occasionally.

Stir in the heavy cream and grated Parmesan cheese until well combined and heated through.

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

Stir in the fresh chopped basil. Taste and adjust seasoning if needed.

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