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Bring a large pot of generously salted water to a rolling boil. Add the 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 is cooking, 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 transfer the cooked sausage to a plate, leaving a small amount of rendered fat in the pan.

Reduce the heat to medium. Add the diced yellow onion to the skillet and cook until softened and translucent, about 5 minutes. Add the minced garlic and red pepper flakes (if using) and cook for another 1 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 10 minutes, allowing the flavors to meld.

Stir in the heavy cream and grated Parmesan cheese until well combined and the cheese has melted into the sauce. Add the cooked Italian sausage back into the skillet.

Add the cooked pasta to the sauce. If the sauce seems 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 extra grated Parmesan cheese and fresh basil, if desired.


Bring a large pot of generously salted water to a rolling boil. Add the 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 is cooking, 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 transfer the cooked sausage to a plate, leaving a small amount of rendered fat in the pan.

Reduce the heat to medium. Add the diced yellow onion to the skillet and cook until softened and translucent, about 5 minutes. Add the minced garlic and red pepper flakes (if using) and cook for another 1 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 10 minutes, allowing the flavors to meld.

Stir in the heavy cream and grated Parmesan cheese until well combined and the cheese has melted into the sauce. Add the cooked Italian sausage back into the skillet.

Add the cooked pasta to the sauce. If the sauce seems 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 extra grated Parmesan cheese and fresh basil, if desired.
