This Creamy Italian Sausage Pasta is flavorful and hearty. Tender pasta is coated in a rich sauce made from chicken broth, cream, tomato paste and browned Italian sausage. The dish is finished with Parmesan cheese, spices, herbs, and a generous helping of spinach, which makes this a quick and easy weeknight Mediterranean meal.

Creamy Italian Sausage Pasta At A Glance
- ⏱ Total Time: 35 minutes
- 🍽 Servings: 4
- 🍝 Cuisine Type: Italian / Mediterranean Comfort
- 🥄 Flavor Profile: Savory browned sausage, a silky tomato-cream sauce, Parmesan richness, and a fresh finish from spinach and herbs.
- 📚 Dietary Info: Contains dairy (cream, Parmesan) and gluten (pasta), but both are easily adapted gluten-free or dairy-free.
- 📦 Storage Notes: Refrigerate in an airtight container for 3-4 days. Reheat gently on the stovetop with a splash of broth or water to loosen the sauce.
- ⭐ Why You'll Love It: A cozy, creamy pasta that feels hearty yet bright, thanks to layers of flavor and a handful of fresh greens. Easy enough for a weeknight and special enough to serve guests.
What Makes This Pasta Special
This pasta stands out for its rich, layered flavor and its lighter, brighter finish. Browning the sausage, caramelizing the tomato paste, and balancing the cream with broth create a silky sauce that never feels heavy. A handful of spinach and fresh herbs brings a fresh lift that makes each bowl feel comforting and vibrant at the same time.
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I make this pasta with ground beef or an all-beef sausage most days instead of pork, and it tastes just as delicious. It is one of those cozy meals that comes together quickly, fills the kitchen with the best aroma, and tastes like something you would happily serve to family or friends.
If you love creamy, comforting dishes, you might also enjoy my Feta Tomato Pasta, French Onion Pasta, Penne Pomodoro, or my Tortellini Pasta Salad. Each one brings its own twist while keeping things simple, flavorful, and easy to fit into your weekly rotation.
Ingredients
You will need the following ingredients to make this creamy pasta with italian sausage:

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Ingredient Notes
- Italian Sausage - Traditional pork sausage gives this pasta its classic savory depth, but I often make it with a beef or turkey for a lighter feel. While it changes the taste slightly, I still enjoyed the pasta. Browning the sausage well builds the flavor base and adds those caramelized bits that melt into the sauce.
- Tomato Paste - Cooking the tomato paste until it deepens in color was an important part of the testing. It removed any sharp, raw taste of the paste and added a concentrated richness that helps balance the cream and lifts the sauce.
- Parmesan Cheese - Freshly grated Parmesan melts smoothly and brings a salty, nutty finish that ties everything together. Pre-grated cheese has a binder and it can make the sauce grainy, so the freshly grated option truly makes a difference.
- Garlic - I have used both the infused oil and the creamy garlic that is made from the Garlic Confit recipe. It's a delicious addition to this dish!
See the recipe card for quantities.
How To Make Creamy Italian Sausage Pasta With Spinach: Step-By-Step
Here are some quick visual instructions. Remember that full instructions with the exact ingredients are in the printable recipe card:

Step 1: Cook the pasta in a large pot with salted water until it is al dente. Reserve a ½ cup of the pasta water, then drain and set the pasta aside. In a large skillet, brown the sausage and then place it in a bowl or plate and set it aside.

Step 2: In the same skillet, saute the onion until soft. Add the garlic, red pepper flakes, and Italian seasoning and saute for a minute. Stir in the tomato paste and cook until the color deepens.

Step 3: Deglaze with the chicken broth and stir in the heavy cream and sausage. Simmer until the sauce thickens slightly.

Step 4: Add the Parmesan cheese and stir. Add the pasta and spinach along with the reserved pasta water if needed. Taste and adjust with salt and pepper.
Pro Tip
Brown the sausage deeply before building the sauce. A well-browned sausage creates the flavorful base that carries the entire dish, giving the cream sauce depth, sweetness, and those little caramelized bits that make every bite taste richer and more balanced.
Variations
- Add roasted cherry tomatoes - Roast a tray of cherry tomatoes at 400 degrees Fahrenheit with a bit of olive oil and salt until they burst. Stir them into the sauce for extra sweetness and color. If you don't want to roast them, just throw cherry tomatoes into the sauce and cook until they start to burst.
- Make it spicy - Use hot Italian sausage or add a pinch of either Aleppo or Calabrian chile flakes for a gentle heat that blends beautifully with the creamy sauce.
- Swap kale for the spinach - Kale adds a hearty, earthy note. It needs an extra minute to soften but holds its texture nicely. I like chopping it into rough slices before adding it to the sauce.
- Add lemon zest - A small amount of zest brightens the sauce and adds a Mediterranean lift without changing the cozy feel of the dish.

Frequently Asked Questions
Yes. You can use half and half instead of heavy cream, or reduce the cream slightly and add a splash of extra broth. The sauce will still be creamy but not as rich.
You can make the sauce a day in advance and store it in the refrigerator. Reheat it gently and toss with freshly cooked pasta just before serving.
Other Main Course Meals

Creamy Italian Sausage Pasta With Spinach
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Equipment
- 1 Stockpot
Ingredients
- 12 ounces short pasta rigatoni or penne work best
- 1 pound Italian sausage mild or sweet, casings removed
- 1 tablespoon extra-virgin olive oil
- 1 small yellow onion finely chopped
- 3 cloves garlic minced
- ½ teaspoon red pepper flakes
- 1 teaspoon dried Italian seasoning or a mix of oregano, basil, and thyme
- 2 tablespoons tomato paste
- ½ cup chicken broth
- 1 cup heavy cream
- ½ cup Parmesan cheese grated, plus extra for serving
- 2 cups fresh spinach
- salt to taste
- ground black pepper to taste
- fresh basil or parsley for garnish
Instructions
- Bring a large pot of salted water to a boil. Cook the pasta until al dente. Reserve a ½ cup of the pasta water, then drain the pasta.12 ounces short pasta
- In a large skillet over medium heat, warm the olive oil. Add the sausage, breaking it up with a spoon. Cook until browned and cooked through, about 6 to 8 minutes. Transfer to a bowl or plate.1 pound Italian sausage, 1 tablespoon extra-virgin olive oil
- In the same skillet, saute the onion until soft, about 3 minutes.1 small yellow onion
- Add the garlic, red pepper flakes, and the Italian seasoning. Cook until fragrant, about 1 minute.3 cloves garlic, ½ teaspoon red pepper flakes, 1 teaspoon dried Italian seasoning
- Stir in the tomato paste. Cook for 1-2 minutes until slightly darkened (deepening the flavor).2 tablespoons tomato paste
- Deglaze the skillet with the chicken broth, scraping up any browned bits from the pan.½ cup chicken broth
- Stir in the heavy cream and return the sausage to the pan.1 cup heavy cream
- Simmer for 3-4 minutes until the sauce thickens slightly.
- Add the Parmesan cheese and stir until smooth.½ cup Parmesan cheese
- Add the drained pasta and spinach. Add the reserved pasta water if the sauce is too thick.2 cups fresh spinach
- Taste and adjust with salt and pepper. Serve topped with more Parmesan and fresh basil or parsley.salt, ground black pepper, fresh basil or parsley
















Gwen Wolken says
You will love this recipe!