Creamy sausage pasta with tomatoes made with Italian sausage, crushed tomatoes, cream, farfalle pasta, basil, and Pecorino Romano.

I’m not saying Creamy Sausage Pasta with Tomatoes fixes everything… but I am saying it fixes a lot. This is the kind of dinner I make when the day’s been long, my brain is fried, and the idea of figuring out something “new” sounds exhausting. You know that feeling where you want comfort, but not boring comfort? Yeah. That’s this pasta.

It’s creamy without being too much. Tomato-y without being sharp. Sausage-y in that cozy, savory way that makes the whole kitchen smell like you actually planned dinner. Even if you absolutely did not. Sound familiar?

The first time I made Creamy Sausage Pasta with Tomatoes, it wasn’t for guests. It wasn’t for a special occasion. It was one of those nights where takeout felt expensive, the fridge looked uninspiring, and I needed something that didn’t involve too many decisions.

I had sausage. I had pasta. I had a can of crushed tomatoes that had been silently judging me from the pantry. So I went with it. No big expectations. And then—of course—the garlic hit the pan, the sausage started browning, and suddenly the kitchen felt warmer. Safer. Like things were under control again.

When I stirred cream into the tomatoes and the sauce turned that soft, blushy orange, I remember thinking, Okay… this might be a keeper. It tasted like something you’d order at a cozy Italian spot on a random Tuesday. Except I was at home, in socks, and no one was rushing me out of a booth.

Why you’ll Love this Creamy Sausage Pasta with Tomatoes?

Here’s my very honest, slightly hesitant opinion: Creamy Sausage Pasta with Tomatoes is one of those rare recipes where nothing feels out of place. The sausage brings richness and saltiness. The tomatoes keep things bright enough so the sauce doesn’t feel heavy. And the cream? It smooths everything out without stealing the show.

Is it fancy? No. Is it exciting every single time? Maybe not in a fireworks way. But it’s reliable. And sometimes, reliability is exactly what you want on a weeknight when you’re already tired before you start cooking.

Ingredient Notes

Let’s talk through the ingredients like real people.

• Italian sausage: Sweet sausage is classic here, but spicy works if you’re feeling bold. Removing the casings makes it crumble nicely.
• Crushed tomatoes: This is the backbone of the sauce, so a decent can helps. Not gourmet—just decent.
• Whipping cream: You don’t need much. Just enough to mellow the tomatoes and make things creamy.
• Farfalle pasta: Bowties hold onto the sauce in the best way, but honestly, use what’s in the cupboard.
• Onion and garlic: Basic, yes. Essential, absolutely.
• Fresh basil: Adds a pop of freshness right at the end. It changes the whole vibe.
• Pecorino Romano: Salty, sharp, and perfect with sausage. Parmesan is fine, but Pecorino feels right.

How to Make Creamy Sausage Pasta with Tomatoes?

This recipe is forgiving. That’s part of its charm.

1. Start with the sausage.
   Heat olive oil in a large skillet and add the sausage with a pinch of crushed red pepper. Break it up as it cooks and let it brown a little. Those browned bits? That’s flavor doing its thing.
2. Add the onion and garlic.
   Once the sausage is cooked, toss in the onion and garlic and cook until softened. This is the moment when someone inevitably wanders into the kitchen asking what smells so good.
3. Make the sauce.
   Add the crushed tomatoes and cream, lower the heat, and let it simmer gently. The sauce thickens quickly, turning into that creamy tomato base that clings to a spoon. Season with salt and pepper. Taste. Adjust. Taste again.
4. Cook the pasta.
   Boil the pasta in generously salted water until just tender. Before draining, save a cup of the pasta water. You might not use it all—but when you need it, you’ll be glad it’s there.
5. Bring it all together.
   Add the pasta to the sauce and toss gently. If it looks a little thick, add pasta water a splash at a time until everything’s coated and glossy.
6. Finish like you mean it.
   Top with fresh basil and a generous shower of Pecorino Romano. Serve immediately. Try not to eat it straight from the pan. (No promises.)

Storage Options

Leftover Creamy Sausage Pasta with Tomatoes keeps well in the fridge for up to 3 days in an airtight container. Reheat gently with a splash of cream or water to loosen the sauce. It’s one of those rare cream pastas that reheats without turning sad.

Variations & Substitutions

Once you’ve made this once, you’ll start tweaking it. That’s normal.

• Spicy version: Hot Italian sausage or extra red pepper flakes.
• Lighter version: Half-and-half instead of cream.
• Different pasta: Penne, rigatoni, shells—anything sturdy.
• Veggie add-ins: Spinach, mushrooms, or roasted red peppers slide right in.
• Cheese swap: Parmesan works if that’s what you have.

What to Serve With Creamy Sausage Pasta with Tomatoes?

This pasta doesn’t need much help.

• Garlic bread: Always.
• Simple green salad: Something crisp balances the creaminess.
• Roasted veggies: Broccoli or asparagus feel right here.
• A glass of red wine: Optional… but kind of perfect.

FAQ

Can I make this ahead of time?
Yes, just add a splash of liquid when reheating.

Is it super heavy?
It’s creamy, but the tomatoes keep it balanced.

Can I freeze it?
You can, but cream sauces are best fresh or refrigerated.

Can I use chicken sausage?
Absolutely. Different flavor, same comfort.

If you’re looking for a dinner that feels cozy, familiar, and quietly satisfying, Creamy Sausage Pasta with Tomatoes is a solid choice. Make it on a night when you don’t want to think too hard, and let me know—did it become one of your go-to pastas too?

Creamy Sausage Pasta with Tomatoes

Creamy Sausage Pasta with Tomatoes is a comforting Italian-inspired dish made with sweet Italian sausage simmered in a creamy tomato sauce and tossed with farfalle pasta, fresh basil, and Pecorino Romano cheese.

Print Pin Rate

Course: Main Course

Cuisine: American-Italian, Italian-Inspired

Keyword: Creamy Sausage Pasta with Tomatoes

Servings: 0

Ingredients

• 2 tbsp olive oil
• 1 lb sweet Italian sausage casings removed
• ½ tsp dried crushed red pepper flakes
• 1 cup onion finely chopped
• 3 garlic cloves minced
• 1 28-oz can crushed tomatoes with added purée
• ½ cup heavy whipping cream
• 1 lb farfalle pasta
• ½ cup fresh basil finely chopped
• Freshly grated Pecorino Romano cheese for serving
• Kosher salt to taste
• Freshly ground black pepper to taste

Instructions

• In a large, heavy-bottomed skillet set over medium-high heat, warm the olive oil. Add the Italian sausage and crushed red pepper flakes. Cook for approximately 5 minutes, breaking the sausage into small pieces, until it is fully cooked and no longer pink.
• Add the chopped onion and minced garlic to the skillet. Continue cooking for 3 minutes, stirring frequently, until the onion becomes tender and translucent.
• Add the crushed tomatoes and heavy whipping cream to the skillet. Reduce the heat to low and allow the mixture to simmer gently for approximately 3 minutes, or until the sauce begins to thicken slightly. Season with kosher salt and freshly ground black pepper to taste.
• Meanwhile, bring a large pot of generously salted water to a rolling boil. Add the farfalle pasta and cook until al dente, according to package instructions. Reserve 1 cup of the pasta cooking liquid, then drain the pasta.
• Return the drained pasta to the pot and add the sausage and tomato cream sauce. Toss gently over medium-low heat until the pasta is evenly coated. If the sauce appears too thick, add the reserved pasta water in ¼-cup increments until the desired consistency is reached.
• Transfer the pasta to a serving dish. Garnish with chopped fresh basil and freshly grated Pecorino Romano cheese before serving.

Notes

To make this recipe gluten free, substitute the farfalle pasta with a certified gluten-free pasta of choice. Verify that the Italian sausage and crushed tomatoes are labeled gluten free, as some brands may contain gluten-based fillers or additives.