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Bring a large pot of salted water to a rolling boil. Add the pasta and cook according to package directions until al dente. Reserve 1 cup of pasta 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 and break it up with a spoon. Cook until browned and cooked through, about 5-7 minutes. Drain any excess fat.

Add the chopped yellow onion to the skillet with the sausage. Cook until softened, about 3-4 minutes.

Stir in the minced garlic and red pepper flakes. Cook for 1 minute until fragrant, being careful not to burn the garlic.

Pour in the crushed tomatoes, salt, and black pepper. Bring the sauce to a simmer, then reduce the 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. Mix until the cheese is melted and the sauce is creamy. If the sauce is too thick, add a splash of the reserved pasta water until it reaches your desired consistency.

Add the drained pasta to the skillet with the sauce. Toss to coat the pasta evenly. Stir in the fresh chopped basil.

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


Bring a large pot of salted water to a rolling boil. Add the pasta and cook according to package directions until al dente. Reserve 1 cup of pasta 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 and break it up with a spoon. Cook until browned and cooked through, about 5-7 minutes. Drain any excess fat.

Add the chopped yellow onion to the skillet with the sausage. Cook until softened, about 3-4 minutes.

Stir in the minced garlic and red pepper flakes. Cook for 1 minute until fragrant, being careful not to burn the garlic.

Pour in the crushed tomatoes, salt, and black pepper. Bring the sauce to a simmer, then reduce the 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. Mix until the cheese is melted and the sauce is creamy. If the sauce is too thick, add a splash of the reserved pasta water until it reaches your desired consistency.

Add the drained pasta to the skillet with the sauce. Toss to coat the pasta evenly. Stir in the fresh chopped basil.

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