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Bring a large pot of salted water to a boil. Add the 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.

Add the chopped onion to the skillet with the sausage and cook until softened, about 3-5 minutes.

Stir in the minced garlic and red pepper flakes, and cook for 1 minute until fragrant.

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 10 minutes, allowing the flavors to meld.

Stir in the heavy cream and grated Parmesan cheese until well combined and the cheese has melted, creating a creamy sauce.

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

Stir in the fresh chopped basil. Taste and adjust seasonings as needed.

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


Bring a large pot of salted water to a boil. Add the 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.

Add the chopped onion to the skillet with the sausage and cook until softened, about 3-5 minutes.

Stir in the minced garlic and red pepper flakes, and cook for 1 minute until fragrant.

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 10 minutes, allowing the flavors to meld.

Stir in the heavy cream and grated Parmesan cheese until well combined and the cheese has melted, creating a creamy sauce.

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

Stir in the fresh chopped basil. Taste and adjust seasonings as needed.

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