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.

Overhead shot of black pan with creamy Italian sausage pasta.

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!

Serve with your favorite veggies, like roasted broccoli, or garlic sauteed broccoli rabe for a full meal.

And if you love creamy sausage recipes, try this creamy sausage and tortellini soup!

Ingredients shown: heavy cream, onion, garlic, Romano cheese, olive oil, canned tomatoes, white wine, tomato paste, basil, hot red pepper flakes, pappardelle pasta, and bulk fennel Italian sausage.

How to make it

Each number corresponds to the numbered written steps below.

  1. 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.
  2. Brown the sausage for about 7 minutes until cooked through and break the sausage up using a spoon or meat masher.

Creamy Italian sausage pasta recipe process shot collage group number one.

  1. Turn the heat down to medium and add the onions.  Saute the onions for 3-4 minutes or until softened.
  2. 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.
  3. Add 3 ounces of tomato paste and cook for 5 minutes while stirring very frequently.
  4. 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.

Recipe process shot collage group number two.

  1. 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.
  2. About 5 minutes before your pasta reaches al dente, add 1 cup of heavy cream to the sauce and mix well to incorporate.
  3. Once the pasta is almost al dente, add it to the sauce and mix well or toss to coat the pappardelle.
  4. If needed, add a touch of pasta water and continue cooking, stirring frequently until the pasta reaches al dente.

Recipe process shot collage group number three.

  1. Remove the pan from the heat and add the Pecorino, mixing well.  Taste test and adjust salt and pepper if needed.
  2. 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!

Grey plate with creamy Italian sausage pasta and grated cheese.

Top tips

  • 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.
  • 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.
  • 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.

Black pan with creamy sausage pappardelle along with block of Pecorino Romano in the background.

More hearty creamy pasta recipes

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Creamy Italian Sausage Pasta

4.98 from 38 votes
Prep: 5 minutes
Cook: 40 minutes
Total: 45 minutes
Servings: 6
Creamy Italian sausage pasta combines mild fennel sausage and al dente pappardelle in a tomato-based cream sauce that's finished with Pecorino Romano and hand-torn fresh basil.


  • 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 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


  • 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!


  • 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.


Calories: 758kcal | Carbohydrates: 69.2g | Protein: 31.6g | Fat: 38.8g | Saturated Fat: 17.9g | Cholesterol: 100mg | Sodium: 735mg | Potassium: 708mg | Fiber: 5.1g | Sugar: 10.8g | Calcium: 171mg | Iron: 5mg

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.

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  1. Teri Cruz says:

    5 stars
    Made this for dinner last night and invited my son, his wife and my 3 year old grandson to join us. In fact, my 3 year old helped me cook it. Everyone raved about it. One small serving left. This is a keeper. Thank you so much.

  2. Kat C says:

    5 stars
    OMG! This ragu is so good. I did have to make what I think are a couple of minor variations based on what I had on hand: half sausage, half mushrooms and some dried basil stirred in with the tomatoes as I did not have any fresh. I served it over a make-ahead creamy polenta. I think I will be dreaming about this until I make it again. My husband said it was delicious, too.

  3. Nicole Mullen says:

    5 stars
    Very good. Easy to make.

  4. Helen A. Osbourne says:

    5 stars
    OMG! I made this dish and it was amazing. The husband loved it and said it was as good as any high end resturant could offer. Then corrected himself and said it was actually better than anything he’s had dining out. He previously raved over your pappardelle ragu, but this was much simpler. I will make the ragu for his birthday. Please never stop posting.

  5. Amber L says:

    5 stars
    I only had parmesan cheese and decided to make this a baked pasta dish to use up 8 oz of shredded mozzarella leftover from Thanksgiving. It was very good! Restaurant quality!

    1. Tara says:

      Hi Amber, we’re so happy you enjoyed and thank you for the comment!

  6. Brad says:

    5 stars
    I made this for dinner last night. It was so easy, and delicious. I am also thrilled to have leftovers for lunch.

    1. Tara says:

      Hi Brad, we’re so happy you liked this one and hope you enjoy the leftovers as well!

  7. Saundra Sillaway says:

    5 stars
    Delicious , do you defat the cooked sausage? My sweet sausage was very fatty ( Dallas Whole Foods) Missing the taster while he is practicing.

    1. Tara says:

      Hi Saundra, if you find the sausage is too fatty, you can definitely defat after cooking. Glad you enjoyed!