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Bring a large pot of salted water to a rolling boil. Add the penne pasta and cook according to package directions until al dente. Before draining, reserve 1/2 cup of the pasta water. Drain the pasta and set aside.

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 wooden spoon. Cook until browned and no longer pink, about 5 to 7 minutes. Drain any excess fat and transfer the cooked sausage to a plate, leaving a small amount of fat in the skillet.

Reduce the heat to medium. Add the chopped yellow onion to the same skillet and cook, stirring occasionally, until softened and translucent, about 3 to 5 minutes.

Add the minced garlic and red pepper flakes (if using) to the skillet. Cook for 1 minute more, stirring constantly, until fragrant. Be careful not to burn the garlic.

Pour in the crushed tomatoes. Bring the sauce to a gentle simmer, then reduce the heat to low, cover, and let it cook for 10 to 15 minutes, allowing the flavors to meld. Stir occasionally to prevent sticking.

Stir in the heavy cream, 1/2 cup of grated Parmesan cheese, and the cooked Italian sausage. Mix well to combine all ingredients.

Add the cooked and drained pasta to the sauce in the skillet. Toss thoroughly to coat the pasta evenly with the creamy tomato sauce. If the sauce appears too thick, add a splash of the reserved pasta water, 1 to 2 tablespoons at a time, until the desired consistency is reached.

Stir in the chopped fresh basil. Taste the pasta and adjust seasoning with additional salt and black pepper if needed.

Serve immediately, garnished with extra fresh basil leaves and a sprinkle of freshly grated Parmesan cheese.


Bring a large pot of salted water to a rolling boil. Add the penne pasta and cook according to package directions until al dente. Before draining, reserve 1/2 cup of the pasta water. Drain the pasta and set aside.

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 wooden spoon. Cook until browned and no longer pink, about 5 to 7 minutes. Drain any excess fat and transfer the cooked sausage to a plate, leaving a small amount of fat in the skillet.

Reduce the heat to medium. Add the chopped yellow onion to the same skillet and cook, stirring occasionally, until softened and translucent, about 3 to 5 minutes.

Add the minced garlic and red pepper flakes (if using) to the skillet. Cook for 1 minute more, stirring constantly, until fragrant. Be careful not to burn the garlic.

Pour in the crushed tomatoes. Bring the sauce to a gentle simmer, then reduce the heat to low, cover, and let it cook for 10 to 15 minutes, allowing the flavors to meld. Stir occasionally to prevent sticking.

Stir in the heavy cream, 1/2 cup of grated Parmesan cheese, and the cooked Italian sausage. Mix well to combine all ingredients.

Add the cooked and drained pasta to the sauce in the skillet. Toss thoroughly to coat the pasta evenly with the creamy tomato sauce. If the sauce appears too thick, add a splash of the reserved pasta water, 1 to 2 tablespoons at a time, until the desired consistency is reached.

Stir in the chopped fresh basil. Taste the pasta and adjust seasoning with additional salt and black pepper if needed.

Serve immediately, garnished with extra fresh basil leaves and a sprinkle of freshly grated Parmesan cheese.
