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Bring a large pot of generously salted water to a rolling boil. Add the bucatini and cook according to package directions until al dente, usually 8-10 minutes. Before draining, reserve 1 cup of the starchy pasta water. Drain the bucatini 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 or spatula. Cook until the sausage is browned and no longer pink, about 5-7 minutes. Drain any excess fat from the skillet if necessary.

Add the chopped yellow onion to the skillet with the sausage and cook, stirring occasionally, until softened and translucent, about 5 minutes. Stir in the minced garlic, dried oregano, and red pepper flakes, cooking for another minute until fragrant.

Stir in the crushed tomatoes and tomato paste. Bring the sauce to a gentle simmer, then reduce the heat to low, cover, and let it cook for 15-20 minutes, allowing the flavors to meld. Stir occasionally to prevent sticking.

Uncover the sauce. Stir in the heavy cream, 1/2 cup of grated Parmesan cheese, and 1/4 cup of chopped fresh basil. Season with kosher salt and black pepper to taste. If the sauce appears too thick, add a splash of the reserved pasta water until it reaches your desired consistency.

Add the drained bucatini directly to the skillet with the creamy sausage sauce. Toss everything together thoroughly to ensure the pasta is evenly coated. If needed, add a little more reserved pasta water to create a silky sauce that clings beautifully to the bucatini.

Divide the creamy sausage and tomato bucatini among serving bowls. Garnish with additional grated Parmesan cheese and fresh basil leaves before serving immediately.


Bring a large pot of generously salted water to a rolling boil. Add the bucatini and cook according to package directions until al dente, usually 8-10 minutes. Before draining, reserve 1 cup of the starchy pasta water. Drain the bucatini 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 or spatula. Cook until the sausage is browned and no longer pink, about 5-7 minutes. Drain any excess fat from the skillet if necessary.

Add the chopped yellow onion to the skillet with the sausage and cook, stirring occasionally, until softened and translucent, about 5 minutes. Stir in the minced garlic, dried oregano, and red pepper flakes, cooking for another minute until fragrant.

Stir in the crushed tomatoes and tomato paste. Bring the sauce to a gentle simmer, then reduce the heat to low, cover, and let it cook for 15-20 minutes, allowing the flavors to meld. Stir occasionally to prevent sticking.

Uncover the sauce. Stir in the heavy cream, 1/2 cup of grated Parmesan cheese, and 1/4 cup of chopped fresh basil. Season with kosher salt and black pepper to taste. If the sauce appears too thick, add a splash of the reserved pasta water until it reaches your desired consistency.

Add the drained bucatini directly to the skillet with the creamy sausage sauce. Toss everything together thoroughly to ensure the pasta is evenly coated. If needed, add a little more reserved pasta water to create a silky sauce that clings beautifully to the bucatini.

Divide the creamy sausage and tomato bucatini among serving bowls. Garnish with additional grated Parmesan cheese and fresh basil leaves before serving immediately.
