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Bring a large pot of generously 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 starchy pasta water. Drain the pasta and set aside.

While the pasta cooks, heat a large skillet or Dutch oven over medium-high heat. Add the Italian sausage, breaking it up with a wooden spoon as it cooks. Brown the sausage thoroughly, about 6-8 minutes. Drain off any excess grease and transfer the cooked sausage to a plate, leaving a small amount of rendered fat in the skillet.

Reduce the heat to medium. Add the olive oil to the skillet, if needed. Add the diced yellow onion and cook until softened and translucent, about 4-5 minutes. Stir in the minced garlic and red pepper flakes (if using) and cook for another 1 minute until fragrant, being careful not to burn the garlic.

Pour in the crushed tomatoes, stir well, and bring the sauce to a gentle simmer. Return the cooked Italian sausage to the skillet. Season with 1/2 teaspoon salt and 1/4 teaspoon black pepper. Let the sauce simmer for 10-12 minutes, allowing the flavors to meld and the sauce to thicken slightly.

Stir in the heavy cream, grated Parmesan cheese, and chopped fresh basil. Mix until the cheese is melted and the sauce is creamy. Taste and adjust seasonings as needed.

Add the cooked and drained pasta to the skillet with the sauce. Toss to coat the pasta evenly. If the sauce seems too thick, add a tablespoon or two of the reserved pasta water at a time until it reaches your desired consistency. Serve immediately, garnished with extra grated Parmesan cheese and fresh basil.


Bring a large pot of generously 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 starchy pasta water. Drain the pasta and set aside.

While the pasta cooks, heat a large skillet or Dutch oven over medium-high heat. Add the Italian sausage, breaking it up with a wooden spoon as it cooks. Brown the sausage thoroughly, about 6-8 minutes. Drain off any excess grease and transfer the cooked sausage to a plate, leaving a small amount of rendered fat in the skillet.

Reduce the heat to medium. Add the olive oil to the skillet, if needed. Add the diced yellow onion and cook until softened and translucent, about 4-5 minutes. Stir in the minced garlic and red pepper flakes (if using) and cook for another 1 minute until fragrant, being careful not to burn the garlic.

Pour in the crushed tomatoes, stir well, and bring the sauce to a gentle simmer. Return the cooked Italian sausage to the skillet. Season with 1/2 teaspoon salt and 1/4 teaspoon black pepper. Let the sauce simmer for 10-12 minutes, allowing the flavors to meld and the sauce to thicken slightly.

Stir in the heavy cream, grated Parmesan cheese, and chopped fresh basil. Mix until the cheese is melted and the sauce is creamy. Taste and adjust seasonings as needed.

Add the cooked and drained pasta to the skillet with the sauce. Toss to coat the pasta evenly. If the sauce seems too thick, add a tablespoon or two of the reserved pasta water at a time until it reaches your desired consistency. Serve immediately, garnished with extra grated Parmesan cheese and fresh basil.
