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Fettuccine with Sausage and Creamy Sauce

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Yields: 4-6 Servings
Prep Time: 10 minutes
Cook Time: 20 minutes
Total Time: 30 minutes

Recipe Intensity: Easy

Ingredients

For the Pasta and Sauce:

  • 12 ounces fettuccine pasta

  • 1 tablespoon olive oil

  • 1 pound mild or hot Italian sausage, casings removed

  • 1 small yellow onion, finely diced

  • 3-4 cloves garlic, minced

  • 1 (24-ounce) jar of high-quality tomato passata or crushed tomatoes

  • ½ cup heavy cream

  • 1 teaspoon dried oregano

  • ½ teaspoon red pepper flakes (optional, for heat)

  • Salt and freshly ground black pepper, to taste

  • ½ cup freshly grated Parmesan cheese, plus more for serving

  • ¼ cup fresh basil, thinly sliced (chiffonade)

Step-by-Step Instructions

Step 1: Brown the Sausage

Bring a large pot of generously salted water to a boil for the fettuccine.

While the water heats, begin the sauce. In a large, high-sided skillet or Dutch oven, heat the olive oil over medium-high heat. Add the Italian sausage, breaking it up with a wooden spoon into bite-sized crumbles. Cook for 5-7 minutes, until the sausage is well-browned and cooked through. The browning is essential for building a deep, savory flavor base for your sauce.

Step 2: Sauté the Aromatics

Once the sausage is browned, reduce the heat to medium. Add the finely diced onion to the skillet and cook for 4-5 minutes, until it becomes soft and translucent. Stir in the minced garlic and cook for another 60 seconds until incredibly fragrant. Be careful not to burn the garlic.

Step 3: Build the Sauce

Pour the tomato passata (or crushed tomatoes) into the skillet with the sausage and onions. Add the dried oregano and red pepper flakes (if using). Stir everything to combine, scraping any browned bits from the bottom of the pan—this is pure flavor!

Bring the sauce to a gentle simmer, then reduce the heat to low and let it cook, uncovered, for about 10 minutes. This allows the flavors to meld and the sauce to thicken slightly.

Step 4: Cook the Pasta

While the sauce simmers, add the fettuccine to the boiling water and cook according to package directions until al dente. Just before draining, reserve about 1 cup of the starchy pasta water. This liquid is a magical tool for perfecting your sauce’s consistency. Drain the pasta.

Step 5: Create Creamy Luxury

Turn off the heat under the skillet. Stir the heavy cream into the tomato and sausage sauce until fully incorporated. The sauce will transform into a beautiful pink-orange color and a luxuriously smooth texture. Stir in the ½ cup of grated Parmesan cheese until it melts seamlessly into the sauce.

Step 6: The Grand Finale – Combine

Add the drained fettuccine directly to the skillet with the creamy sausage sauce. Using a pair of tongs, toss the pasta vigorously until every strand is beautifully coated. If the sauce is thicker than you’d like, add a splash of the reserved pasta water, a little at a time, until it reaches your desired silky consistency. The starch in the water helps the sauce cling to the pasta perfectly.

Step 7: Serve Immediately

Taste the pasta and adjust seasoning with salt and black pepper as needed. Stir in most of the fresh basil, reserving a little for garnish. Divide the pasta among warm bowls, garnish with the remaining basil and an extra sprinkle of Parmesan cheese. Serve immediately.

Chef’s Notes & Recipe Variations

  • Sausage Selection: The choice between mild and hot Italian sausage dictates the dish’s character. Mild sausage creates a family-friendly, herb-forward dish, while hot sausage introduces a wonderful, spicy kick.

  • Cream Substitute: For a slightly lighter version, you can use half-and-half, but be aware the sauce will be less rich and may not thicken as much. Do not use milk, as it is likely to curdle.

  • The Power of Passata: Using a smooth tomato passata creates a velvety, restaurant-style sauce. Crushed tomatoes will yield a slightly chunkier, more rustic texture. Both are delicious.

  • Vegetable Boost: Feel free to add vegetables! Sliced mushrooms can be sautéed with the onions, or a handful of fresh spinach can be stirred in at the very end until just wilted.

  • Wine Pairing: A medium-bodied red wine like a Chianti or Sangiovese stands up beautifully to the sausage and tomato, while a crisp white like Pinot Grigio can cut through the richness of the cream.

Storage and Reheating

This pasta is best enjoyed fresh. However, leftovers can be stored in an airtight container in the refrigerator for up to 3 days. The pasta will continue to absorb the sauce, so it will be much thicker upon reheating.

To reheat, place a portion in a skillet with a splash of water, broth, or cream over low heat. Gently stir until warmed through. The microwave can be used (heat in 30-second intervals, stirring in between), but the stovetop method yields a far superior texture.

Nutrition Information

(Please note: The following nutrition information is an estimate and can vary based on specific ingredients and portion sizes.)

Serving Size: 1/6 of the recipe

  • Calories: ~620

  • Total Fat: 32g

  • Saturated Fat: 13g

  • Cholesterol: 95mg

  • Sodium: 850mg

  • Total Carbohydrates: 58g

  • Dietary Fiber: 4g

  • Sugars: 8g

  • Protein: 25g

Dietary Note: This recipe is not suitable for vegetarian, gluten-free (unless using gluten-free pasta), or dairy-free diets. It is relatively high in saturated fat and sodium due to the sausage, cream, and cheese.

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