Creamy Tomato Pasta with Sausage

Listen up, pasta lovers! This creamy tomato pasta with sausage is about to rock your weeknight dinner world. It’s that perfect balance of rich, savory flavors with just enough creaminess to make you close your eyes and savor every bite. And the best part? It comes together in just about 35 minutes from start to finish.

The magic happens when that Italian sausage releases its flavor-packed oils into the pan, creating the foundation for our sauce. Then we build layers with garlic, tomatoes, and a splash of cream that transforms everything into silky perfection. The fresh spinach adds a pop of color and nutrition that wilts right into the sauce. Trust me, this is comfort food that doesn’t mess around.

Ingredients

• 1/2 lb. Italian sausage (hot, mild or sweet)
• 2 cloves garlic
• 2 Tbsp tomato paste
• 1 28oz. can crushed tomatoes
• 1 tsp Italian seasoning blend
• 1/2 cup water
• 1/2 lb. pasta (penne, rigatoni, or fusilli work best)
• 1/3 cup heavy cream
• 4 oz. fresh spinach

Steps

1. Heat a deep skillet or Dutch oven over medium heat until hot. Add the Italian sausage and cook for 6-8 minutes, breaking it up with a wooden spoon as it cooks. Look for a deep brown color on the meat – this caramelization adds tremendous flavor. Mince two cloves of garlic and add to the browned sausage, sautéing for 1 minute more. The garlic should become fragrant but not brown, which would make it bitter.
2. Add the tomato paste to the meat and stir for 30 seconds to slightly caramelize it. This step deepens the tomato flavor significantly. Next, add the crushed tomatoes, Italian seasoning, and water. Stir thoroughly to combine and use your spoon to scrape up any browned bits from the bottom of the skillet – these contain concentrated flavor that will enhance your sauce. Bring the sauce to a gentle simmer over medium heat (look for small bubbles consistently breaking the surface).
3. Once simmering, place a tilted lid on top (allowing about a 1-inch gap for steam to escape while blocking splatter) and reduce the heat to medium-low. Let the sauce simmer for 15-20 minutes, stirring occasionally. The sauce should reduce slightly and develop a deeper red color as it cooks.
4. While the sauce simmers, bring a large pot of water to a rolling boil over high heat. Once boiling vigorously, add 1 tablespoon salt and the pasta. Stir immediately to prevent sticking. Continue to boil until the pasta is al dente (7-10 minutes depending on the variety) – test by taking a piece out and biting through it; you should see a tiny white dot in the center. Drain the pasta in a colander but do not rinse, as the starch helps the sauce adhere.
5. After the pasta has cooked and the sauce has simmered, reduce the heat to low and stir the heavy cream into the pasta sauce. The sauce should take on a beautiful orange-pink color. Add the fresh spinach and stir gently until just wilted, about 1-2 minutes. The spinach will reduce dramatically in volume, so don’t worry if it seems like too much at first.
6. Finally, add the cooked and drained pasta directly to the sauce and stir to combine thoroughly. Allow the pasta to sit in the sauce for 1-2 minutes before serving, which helps it absorb some of the flavors. Serve hot, optionally topped with grated Parmesan cheese and red pepper flakes for an extra kick.

Smart Swaps

• Use half-and-half instead of heavy cream (use 1/2 cup) for a lighter version
• Substitute turkey Italian sausage for pork to reduce fat while maintaining flavor
• Try frozen chopped kale (about 6 oz) instead of spinach for more texture and nutrients
• For a vegetarian version, use 8 oz. plant-based Italian sausage or 1 cup sliced mushrooms sautéed until golden

Make It Diabetes-Friendly

• Replace regular pasta with 1/2 lb. lentil or chickpea pasta to reduce carbs by approximately 15g per serving while adding protein and fiber
• Use 1/4 cup unsweetened almond milk mixed with 1 Tbsp cream cheese instead of heavy cream to lower the carb count by 3g per serving
• Increase the spinach to 6 oz. and reduce pasta to 6 oz. to improve the carb-to-fiber ratio
• Serve with a side salad dressed with olive oil and vinegar to slow carbohydrate absorption

Pro Tips

• For maximum flavor, let the finished pasta rest for 5 minutes before serving – this allows the pasta to absorb more sauce
• The sauce freezes beautifully without the pasta – make a double batch and freeze half for up to 3 months
• If the sauce seems too thick after adding the pasta, add 2-3 Tbsp of the reserved pasta cooking water to reach your desired consistency
• For a restaurant-quality finish, drizzle each serving with a teaspoon of high-quality olive oil and a sprinkle of fresh basil