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Bring a large pot of salted water to a rolling boil. Add the penne pasta and cook according to package directions until al dente, about 10-12 minutes. Reserve 1 cup of the pasta water, then drain the pasta.

While the pasta cooks, heat 1 tablespoon of 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. Remove the sausage from the skillet and set aside, leaving any rendered fat in the pan.

Reduce the heat to medium. Add 1 tablespoon of olive oil to the same skillet. Add the diced yellow onion and cook until softened and translucent, about 5 minutes. Add the minced garlic and red pepper flakes (if using) and cook for 1 minute more until fragrant.

Stir in the crushed tomatoes, 1/2 teaspoon of salt, and 1/4 teaspoon of black pepper. Bring the sauce to a simmer, then reduce the heat to low, cover, and cook for 10 minutes, stirring occasionally.

Stir in the heavy cream, grated Parmesan cheese, and the cooked Italian sausage. If the sauce is too thick, add a splash of the reserved pasta water until the desired consistency is reached. Cook for 2-3 minutes until heated through.

Add the drained pasta to the skillet with the sauce and toss to coat. Stir in the fresh basil. Serve immediately, garnished with extra Parmesan cheese and fresh basil, if desired.


Bring a large pot of salted water to a rolling boil. Add the penne pasta and cook according to package directions until al dente, about 10-12 minutes. Reserve 1 cup of the pasta water, then drain the pasta.

While the pasta cooks, heat 1 tablespoon of 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. Remove the sausage from the skillet and set aside, leaving any rendered fat in the pan.

Reduce the heat to medium. Add 1 tablespoon of olive oil to the same skillet. Add the diced yellow onion and cook until softened and translucent, about 5 minutes. Add the minced garlic and red pepper flakes (if using) and cook for 1 minute more until fragrant.

Stir in the crushed tomatoes, 1/2 teaspoon of salt, and 1/4 teaspoon of black pepper. Bring the sauce to a simmer, then reduce the heat to low, cover, and cook for 10 minutes, stirring occasionally.

Stir in the heavy cream, grated Parmesan cheese, and the cooked Italian sausage. If the sauce is too thick, add a splash of the reserved pasta water until the desired consistency is reached. Cook for 2-3 minutes until heated through.

Add the drained pasta to the skillet with the sauce and toss to coat. Stir in the fresh basil. Serve immediately, garnished with extra Parmesan cheese and fresh basil, if desired.
