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Bring a large pot of salted water to a rolling boil for the pasta (use 1 tablespoon of salt).

While the water heats, heat 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 yellow onion to the skillet with the sausage and cook until softened, about 3-4 minutes.

Stir in the minced garlic and red pepper flakes (if using) and cook for another minute until fragrant.

Pour in the crushed tomatoes, salt, and black pepper. Bring the sauce to a simmer, then reduce heat to low, cover, and let it cook for at least 15 minutes to allow the flavors to meld. Stir occasionally.

While the sauce simmers, add the pasta to the boiling water and cook according to package directions until al dente. Reserve 1 cup of pasta water before draining.

Uncover the sauce. Stir in the heavy cream and grated Parmesan cheese until well combined and creamy. Taste and adjust seasoning if needed.

Add the drained pasta directly 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 fresh chopped basil. Serve immediately, garnished with additional grated Parmesan cheese if desired.


Bring a large pot of salted water to a rolling boil for the pasta (use 1 tablespoon of salt).

While the water heats, heat 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 yellow onion to the skillet with the sausage and cook until softened, about 3-4 minutes.

Stir in the minced garlic and red pepper flakes (if using) and cook for another minute until fragrant.

Pour in the crushed tomatoes, salt, and black pepper. Bring the sauce to a simmer, then reduce heat to low, cover, and let it cook for at least 15 minutes to allow the flavors to meld. Stir occasionally.

While the sauce simmers, add the pasta to the boiling water and cook according to package directions until al dente. Reserve 1 cup of pasta water before draining.

Uncover the sauce. Stir in the heavy cream and grated Parmesan cheese until well combined and creamy. Taste and adjust seasoning if needed.

Add the drained pasta directly 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 fresh chopped basil. Serve immediately, garnished with additional grated Parmesan cheese if desired.
