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Bring a large pot of salted water to a 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 fat.

Add the diced 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, kosher salt, and black pepper. Bring the sauce to a simmer, then reduce the 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 and drained pasta to the skillet.

Add 1/2 cup of the reserved pasta water to the sauce and toss to coat the pasta. If the sauce is too thick, add more pasta water, 1-2 tablespoons at a time, until it reaches your desired consistency. Stir in the chopped fresh basil.

Serve immediately, garnished with additional fresh basil and grated Parmesan cheese.


Bring a large pot of salted water to a 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 fat.

Add the diced 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, kosher salt, and black pepper. Bring the sauce to a simmer, then reduce the 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 and drained pasta to the skillet.

Add 1/2 cup of the reserved pasta water to the sauce and toss to coat the pasta. If the sauce is too thick, add more pasta water, 1-2 tablespoons at a time, until it reaches your desired consistency. Stir in the chopped fresh basil.

Serve immediately, garnished with additional fresh basil and grated Parmesan cheese.
