This Fettuccine with Creamy Tomato Italian Sausage Sauce combines the rich flavors of Italian sausage with a creamy tomato sauce, all served over tender fettuccine pasta. It’s a hearty and satisfying dish that’s perfect for a cozy dinner at home.


  • 12 ounces fettuccine pasta
  • 1 tablespoon olive oil
  • 1 pound Italian sausage (mild or spicy, according to preference), casings removed
  • 1 medium onion, finely chopped
  • 3 cloves garlic, minced
  • 1 can (28 ounces) crushed tomatoes
  • 1 cup heavy cream
  • 1 teaspoon dried oregano
  • 1 teaspoon dried basil
  • Salt and freshly ground black pepper to taste
  • 1/2 cup grated Parmesan cheese, plus more for serving
  • Fresh basil leaves, for garnish


  1. Cook the Pasta: Bring a large pot of salted water to a boil. Add the fettuccine and cook according to package instructions until al dente. Drain, reserving 1 cup of pasta water, and set aside.
  2. Cook the Sausage: While the pasta is cooking, heat the olive oil in a large skillet over medium heat. Add the Italian sausage, breaking it apart with a spoon. Cook until browned and no longer pink, about 5-7 minutes. Transfer the cooked sausage to a plate and set aside.
  3. Sauté Onion and Garlic: In the same skillet, add the chopped onion and sauté until translucent, about 5 minutes. Add the minced garlic and cook for an additional minute until fragrant.
  4. Make the Sauce: Add the crushed tomatoes, heavy cream, dried oregano, and dried basil to the skillet. Stir to combine. Bring the sauce to a simmer, then reduce the heat and let it simmer for about 10 minutes, allowing the flavors to meld together. Season with salt and pepper to taste.
  5. Combine Pasta and Sauce: Return the cooked sausage to the skillet with the tomato cream sauce. Add the cooked fettuccine to the skillet and toss well to coat the pasta evenly with the sauce. If the sauce is too thick, add a bit of the reserved pasta water to reach your desired consistency.
  6. Finish the Dish: Stir in the grated Parmesan cheese until melted and well combined with the sauce.
  7. Serve: Divide the pasta among plates or bowls. Garnish with additional grated Parmesan cheese and fresh basil leaves.

Nutrition Facts (per serving):

  • Calories: 700
  • Fat: 40g
  • Carbohydrates: 60g
  • Protein: 30g

Prep and Cooking Time:

  • Prep Time: 15 minutes
  • Cooking Time: 25 minutes


  • Serves: 4-6 people

Fettuccine with Creamy Tomato Italian Sausage Sauce is a delightful dish that’s rich in flavor and texture. The combination of creamy tomato sauce and savory sausage makes for a satisfying meal that’s sure to please everyone at the table. Enjoy this comforting pasta dish with your favorite side salad or garlic bread.

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