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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 the pasta.

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 grease and set the sausage aside.

Reduce the heat to medium. Add the chopped yellow onion to the same skillet and cook until softened, about 3-4 minutes. Add the minced garlic and red pepper flakes (if using) and cook for another minute until fragrant.

Stir in the crushed tomatoes, 1/2 teaspoon of salt, and 1/4 teaspoon of black pepper. Bring the sauce to a gentle simmer, then reduce heat to low, cover, and let it cook for 10 minutes to allow the flavors to meld.

Remove the lid and stir in the heavy cream and grated Parmesan cheese until well combined and heated through. Add the cooked Italian sausage back into the sauce.

Add the drained pasta to the skillet with 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. Stir in the chopped fresh basil.

Serve immediately, garnished with extra 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 the pasta.

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 grease and set the sausage aside.

Reduce the heat to medium. Add the chopped yellow onion to the same skillet and cook until softened, about 3-4 minutes. Add the minced garlic and red pepper flakes (if using) and cook for another minute until fragrant.

Stir in the crushed tomatoes, 1/2 teaspoon of salt, and 1/4 teaspoon of black pepper. Bring the sauce to a gentle simmer, then reduce heat to low, cover, and let it cook for 10 minutes to allow the flavors to meld.

Remove the lid and stir in the heavy cream and grated Parmesan cheese until well combined and heated through. Add the cooked Italian sausage back into the sauce.

Add the drained pasta to the skillet with 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. Stir in the chopped fresh basil.

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