Creamy Italian sausage pasta combines sweet fennel sausage and al dente pappardelle tossed with a velvety tomato-based cream sauce that’s finished with grated Pecorino and hand-torn fresh basil. This simple but hearty pasta can be on your table in about 45 minutes.

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Editor’s Note: Originally published on 9/28/2018. Updated with full process shots and expanded info.
Sausage, cream, pasta: these three words, when combined, might just be my favorite phrase ever!
And these are the main ingredients in this creamy Italian sausage pasta.
The tomato-cream sauce provides a velvety backdrop to the sweet fennel sausage, and the pappardelle proves to be the perfect medium to deliver both right to your mouth!
And if you love Italian sausage recipes, try this pasta alla zozzona or creamy sausage and tortellini soup!
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Recipe Ingredients
All ingredients for this recipe are shown in the pic below and special notes are made in this bulleted list to assist you.
- Sausage. I used mild Italian bulk sausage with fennel for this recipe. If you can’t find bulk sausage, you can buy sausage links and remove the meat from its casing. If you can’t find fennel sausage, you could add 2 teaspoons of loose fennel seed if desired.
- Pasta. I love pappardelle for hearty pasta dishes, like my short rib ragu, so that’s what I’ve used here. If you can’t find pappardelle, you can use rigatoni, paccheri, or any other pasta that will hold up to the weight of the cream and sausage.
- Cream. I strongly recommend using heavy cream for this creamy sausage pasta because it won’t break. Using milk or half and half can lead to a broken sauce due to the acid if the wine and tomatoes. If you insist on using milk or half and half, tempering is recommended.
- Wine. I used a Sauvignon Blanc for this recipe but any dry white wine will do. If you prefer to not use wine, you can replace the liquid with water or stock.
See the recipe card for full information on ingredients and quantities.
How to make it
Each number corresponds to the numbered written steps below.
- Bring a large pot of salted water (2 tablespoons of Morton’s kosher salt per gallon of water) to boil. Dice 1 medium onion and slice 5 cloves of garlic. Grate 3/4 cup of Pecorino Romano. Heat a large pan or Dutch oven over medium-high heat and add 2 tablespoons of extra virgin olive oil and 1 pound of bulk mild Italian sausage.
- Brown the sausage for about 7 minutes until cooked through and break the sausage up using a spoon or meat masher.
- Turn the heat down to medium and add the onions. Saute the onions for 3-4 minutes or until softened.
- Add the garlic and saute for 1-2 minutes or until lightly golden. Add a 1/2 teaspoon of crushed red pepper flakes and cook for another 30 seconds.
- Add 3 ounces of tomato paste and cook for 5 minutes while stirring very frequently.
- Turn the heat to medium-high and add 3/4 cup of dry white wine. Continue to cook for 1-2 minutes or until the wine has reduced by about half. Scrape the bottom of the pan to dislodge any brown bits.
- Add 14 ounces of crushed tomatoes (can be whole plum tomatoes, either hand-crushed or blender pulsed), and bring the sauce to a boil. Once boiling, reduce the heat to a simmer. Meanwhile, add 1 lb of pappardelle pasta to the boiling water, cooking it to 1 minute less than al dente.
- About 5 minutes before your pasta reaches al dente, add 1 cup of heavy cream to the sauce and mix well to incorporate.
- Once the pasta is almost al dente, add it to the sauce and mix well or toss to coat the pappardelle.
- If needed, add a touch of pasta water and continue cooking, stirring frequently until the pasta reaches al dente.
- Remove the pan from the heat and add the Pecorino, mixing well. Taste test and adjust salt and pepper if needed.
- Top with roughly a 1/4 cup worth of hand-torn fresh basil. If the pasta dries out at all, add a touch more reserved pasta water and stir to combine. Serve your creamy Italian sausage pasta with more grated Pecorino and enjoy!
Top tip
Save your pasta water! As with any cream sauce pasta, it’s so important to save your pasta water! Cream sauces have a tendency to dry out and pasta water is the perfect antidote to bring it back to its intended glossy consistency.
More hearty creamy pasta recipes
- Gorgonzola cream sauce pasta – with sausage and peas.
- Pasta alla boscaiola – with mushrooms, rosemary, and sausage.
- Pasta alla Norcina – sausage, cream, nutmeg, and white wine.
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Creamy Italian Sausage Pasta
Ingredients
- 1 pound pappardelle
- 1 pound bulk mild Italian sausage
- 2 tablespoons extra virgin olive oil
- 1 medium onion diced
- 5 cloves garlic sliced
- 1/2 teaspoon crushed hot red pepper flakes
- 3 ounces tomato paste
- 3/4 cup dry white wine
- 1 14-ounce can plum tomatoes hand crushed or blender pulsed
- 1 cup heavy cream
- 2 cups reserved pasta water will most likely not need all of it
- 3/4 cup Pecorino Romano grated
- salt and pepper to taste
- 1/4 cup basil leaves hand torn
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Instructions
- Bring a large pot of salted (2 tablespoons kosher salt) water to boil.
- Heat a very large pan or Dutch oven to medium-high heat then add in the olive oil and sausage. Brown the sausage until almost cooked through (about 7 minutes).
- Turn the heat down to medium and add the onions to the pan. Saute for 3-4 minutes or until softened then add the garlic and cook for another 1-2 minutes or until lightly golden. Add the red pepper flakes and cook for another 30 seconds.
- Add the tomato paste and cook for 5 minutes stirring frequently.
- Turn the heat to medium-high and add the wine. Cook for 1-2 minutes to reduce the wine by about half. Scrape the bottom of the pan with a wooden spoon to remove all of the brown bits.
- Add the plum tomatoes to the pot and bring to a boil. Once boiling, lower the heat to a simmer. At this time begin cooking the pasta to 1 minute less than al dente.
- About 5 minutes before the pasta has finished cooking add the cream and mix well to incorporate.
- Once the pasta is almost al dente add it to the sauce and mix to coat. Add a bit of pasta water if needed to loosen things up. Continue to cook, stirring frequently, until the pasta is a perfect al dente.
- Remove the pan from the heat. Add the Pecorino, mix well, then taste test. Season with salt and pepper if required then add the basil.
- If the pasta gets at all dry before serving simply add a bit more of the reserved pasta water and stir to combine. Serve with grated Pecorino. Enjoy!
Notes
- Makes 6 very large servings or 8 normal-sized ones.
- If the pasta dries out at all just add a touch of the reserved pasta water to loosen it up and mix well before serving.
- Serve with extra grated Pecorino Romano cheese.
- Leftovers can be saved for up to 3 days and can be reheated on the stovetop or the microwave.
Nutrition
Nutrition information is automatically calculated, so should only be used as an approximation.
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This recipe was originally published on September 28, 2018. It was completely updated on April 10, 2023.
The recipe specifies 14 ounces of tomatoes but your photograph shows a 28 ounce can. I’m going to make this tonight and will use 28 ounces since 14 seems too little. Your advice please. Thanks!
Hi Edward, the 14 ounces is correct because there’s 3 ounces of tomato paste, cream, wine, and pasta water. You can certainly use 28 ounces, but you will likely have more sauce than you need.