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Creamy Rotel Pasta with Sausage

Creamy Rotel Pasta with Sausage is wonderfully creamy and cheesy with lots of spice. Can be made in just 20 minutes for a quick and easy weeknight meal.

Creamy Rotel Pasta with Sausage in a bowl.

A combination of heavy cream, half-and-half, and cream cheese makes this pasta ultra creamy. A can of Rotel tomatoes and green chiles gives this dish a little Southwestern flavor.

How To Make Creamy Rotel Pasta with Shrimp

  1. Cook the pasta, reserving about 1/2 a cup of the cooking liquid right before you drain the pasta.
  2. While the pasta is cooking, brown the sausage. Remove it from the pan.
  3. To the same pan, melt the butter and cook the onion and garlic.
  4. Add the flour and cook for 1 minute.
  5. Whisk in the half-and-half, heavy cream, and tomatoes. Simmer.
  6. Add the cream cheese, Mexican cheese and seasonings.
  7. Mix in the pasta and sausage. If too thick and not creamy enough, add the reserved pasta liquid.
Creamy Pasta wit Rotel Tomatoes and Sausage in a white bowl with parsley in background.

What To Serve With This Dish

This is a calorie laden dish so it’s best to keep portions small and serve with a green salad and maybe some Pepperoncini Garlic Bread. Steamed broccoli is also a good choice.

How Spicy Is This Dish?

If you use “Hot” sausage and “Hot” Rotel tomatoes, they along with the cajun seasoning will make this dish fairly spicy. Add a pinch of cayenne pepper for more heat.

Recipe Tips

  • Other types of pasta can be used instead of rotini. Penne, ziti, cavatappi, and linguine all work well.
  • I use “Hot” Italian sausage but you can use mild if you want to cut out the spice or you can use a breakfast sausage like Jimmy Dean.
  • Best served shortly after cooking. The sauce gets absorbed into the pasta over time. Leftovers will keep for 3 to 4 days in an airtight container in the refrigerator. You may need to add a little milk when you reheat.
Creamy Rotel Pasta with Sausage in bowl with parsley in background.

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Creamy Rotel Pasta with Sausage in a bowl.

Creamy Rotel Pasta with Sausage

Creamy Rotel Pasta with Sausage is wonderfully creamy and cheesy with lots of spice. Can be made in under 20 minutes for a quick and easy weeknight meal.
PREP: 10 minutes
COOK: 10 minutes


  • 16 ounces pasta, rotini, cavatappi, or penne work well
  • 1/2 cup reserved pasta water
  • 16 ounces hot Italian sausage
  • 2 tablespoons butter
  • 1/2 medium sweet or yellow onion, diced
  • 3 garlic cloves, minced
  • 2 tablespoons all-purpose flour
  • 1 cup heavy cream
  • 1 cup half-and-half
  • 1 (10-ounce) can Rotel tomatoes, undrained
  • 1 (14.5-ounce) can petite diced tomatoes, drained
  • 4 ounces cream cheese, cubed and softened
  • 1 cup shredded Mexican cheese
  • 1 teaspoon Cajun or Creole seasoning
  • 1/2 teaspoon salt
  • 1/2 teaspoon black pepper
  • 1 tablespoon chopped fresh parsley


  • Cook pasta in salted water according to package directions, reserving 1/2 cup of the cooking liquid. Drain well.
  • While the pasta cooks, Brown and crumble the sausage in a large nonstick skillet. When no pink is left, remove it with a slotted spoon and set it on a paper towel-lined plate.
  • Wipe skillet clean and add butter. Place over medium-high heat.
    When butter is melted, add onion and cook 3 minutes.
  • Add garlic and cook 1 more minute.
  • Sprinkle flour into skillet and cook and stir for 1 minute.
  • Whisk in heavy cream and half-and-half. Bring to a simmer and then add Rotel tomatoes and diced tomatoes. Simmer for a few minutes.
  • Add cream cheese and Mexican cheese and stir until melted.
  • Add Cajun seasoning, salt and pepper.
  • Return sausage to skillet. Add pasta and mix everything together. If skillet isn't big enough, transfer everything to a bowl to mix together.
    If sauce is too thick or the pasta is too dry, add in the reserved pasta liquid.
  • Garnish with parsley and serve.


Calories: 707kcal
Course: Dinner
Cuisine: Southern
Keyword: pasta, sausage

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