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Bring a large pot of salted water to a rolling boil. Add the pasta and cook according to package directions until al dente. Reserve 1 cup of pasta water before draining.

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 off any excess fat.

Reduce the heat to medium. Add the diced yellow onion to the skillet with the sausage and cook until softened, about 3-5 minutes.

Stir in the minced garlic and red pepper flakes. Cook for 1 minute until fragrant, being careful not to burn the garlic.

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 10-15 minutes, allowing the flavors to meld.

Stir in the heavy cream and grated Parmesan cheese until well combined and the cheese has melted. If the sauce is too thick, add a splash of the reserved pasta water until it reaches your desired consistency.

Add the cooked and drained pasta to the skillet with the sauce. Toss to coat the pasta evenly. Stir in the chopped fresh basil.

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


Bring a large pot of salted water to a rolling boil. Add the pasta and cook according to package directions until al dente. Reserve 1 cup of pasta water before draining.

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 off any excess fat.

Reduce the heat to medium. Add the diced yellow onion to the skillet with the sausage and cook until softened, about 3-5 minutes.

Stir in the minced garlic and red pepper flakes. Cook for 1 minute until fragrant, being careful not to burn the garlic.

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 10-15 minutes, allowing the flavors to meld.

Stir in the heavy cream and grated Parmesan cheese until well combined and the cheese has melted. If the sauce is too thick, add a splash of the reserved pasta water until it reaches your desired consistency.

Add the cooked and drained pasta to the skillet with the sauce. Toss to coat the pasta evenly. Stir in the chopped fresh basil.

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