This creamy sausage rigatoni is a rich, comforting pasta dinner made with tender rigatoni, savory Italian sausage, and a smooth Parmesan cream sauce. It’s an easy weeknight meal that feels cozy, filling, and restaurant-worthy without complicated steps.
Bring a large pot of salted water to a boil. Cook rigatoni until just al dente. Reserve ½ cup pasta water, then drain and set aside.
Heat olive oil in a large skillet over medium heat. Add Italian sausage and cook, breaking it apart, until browned and fully cooked. Transfer sausage to a plate.
In the same skillet, add onion and cook for 3–4 minutes until softened. Stir in garlic and cook for 30 seconds until fragrant.
Lower heat and pour in heavy cream, stirring gently. Add Parmesan cheese and stir until smooth.
Season with salt, pepper, and red pepper flakes.
Return sausage to the skillet, then add cooked rigatoni. Toss to coat, adding reserved pasta water a little at a time until sauce reaches desired consistency.
Stir in optional add-ins if using. Cook 1–2 minutes more.
Serve immediately with extra Parmesan on top.
Notes
Use freshly grated Parmesan for the smoothest sauce.
Avoid high heat once cream is added to prevent separation.
Sauce thickens as it cools—add a splash of cream when reheating if needed.