Italian Sausage Rigatoni with Spicy Cream Sauce

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Sausage with Rigatoni in Spicy Cream Sauce is pure comfort food and makes an easy and delicious weeknight meal. The flavor starts with onion and garlic which are sauteed with the sausage for maximum flavor.

Italian Sausage Rigatoni with Spicy Cream Sauce


A can of diced tomatoes and a can of tomato sauce are then added. I think it’s nice to have a few chunks of tomato in an otherwise creamy sauce. A tablespoon of tomato paste really ups the tomato flavor.

Sausage Rigatoni with Spicy Tomato Sauce


Sausage Rigatoni with Spicy Tomato Cream Sauce


This recipe has the perfect balance between tomatoes and cream.  A half a cup of cream makes it plenty rich and creamy, but doesn’t make it heavy.

A little salt, pepper, dried basil (you could use fresh), and red pepper flakes are all that’s needed for the sauce as far as seasoning.

Parmesan cheese is added last minute to the sauce for more flavor, plus it helps thicken the sauce. Use either hot or mild sausage. I usually go with hot.

Whenever I make this meal, I think- I don’t cook rigatoni nearly enough! I love the chewiness and substance it has.

Sausage Rigatoni with Spicy Tomato Cream Sauce


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Sausage Rigatoni with Spicy Tomato Cream Sauce

Italian Sausage Rigatoni with Spicy Cream Sauce

Course: Main Course
Cuisine: American
Prep Time: 5 minutes
Cook Time: 25 minutes
Total Time: 30 minutes
Servings: 5
Calories: 740kcal
Author: Christin Mahrlig
Italian Sausage Rigatoni in Spicy Cream Sauce makes an easy weeknight meal. The sauce has the perfect balance between tomatoes and cream.
Print Recipe


  • 12 ounces Rigatoni pasta
  • 1 tablespoon olive oil
  • 1 medium onion, chopped
  • 1 pound Italian sausage Remove from casings if in casings, use either sweet or spicy
  • 3 cloves garlic, minced
  • 1 (14.5-ounce) can diced tomatoes, undrained
  • 1 (8-ounce) can tomato sauce
  • 1 tablespoon tomato paste
  • 1/2 teaspoon dried basil
  • 1/2 teaspoon salt
  • 1/2 teaspoon red pepper flakes
  • 1/4 teaspoon black pepper
  • 1/2 cup heavy cream
  • 1/2 cup grated Parmesan cheese


  • Heat olive oil in a large pan and cook onion until it starts to soften. Add sausage, and break it into pieces with a wooden spoon as it cooks.
  • When sausage is no longer pink, add garlic and cook for 1 minute. Drain off any excess fat.
  • Add diced tomatoes, tomato sauce, tomato paste, basil, salt, red pepper flakes, and black pepper and simmer until thickened, about 15 minutes.
  • Meanwhile, cook pasta according to package directions. Drain and place drained pasta in a large bowl.
  • Add cream and simmer another 5 minutes, Turn heat to low and stir in Parmesan cheese.
  • Pour sauce over pasta and toss to coat.


Calories: 740kcal


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82 thoughts on “Italian Sausage Rigatoni with Spicy Cream Sauce

  1. I want to make this for tonight’s meal but I’m out of Parmesan cheese and I can’t go out to buy some. I have Swiss cheese, mozzarella, provolone, montery jack. Is any of them I can use as a substitute?

  2. OMG! Soooooooo goooooooood!!!!! Absolutely delicious! So easy to cook I find it hard to believe anyone could screw this up! Just enough heat to to notice but not enough to turn away children too.

  3. Made this for supper tonight and it was delicious. I accidentally left out the tomato paste, but it still tasted great. This recipe is a keeper and will definitely be made again and again.

  4. just made this tonight and it was so good. I made it all in one large fry pan. The only thing that I did not have was the cream so it was just the tomatoes/sauce and paste. This will be a keeper recipe, thanks.

  5. I made this tonight for dinner. OMG!! So good. Used a 16 oz. box of rigatoni, and it still was saucy enough.

  6. Delicious! Made this for my boyfriend and I last night and loved it! Lots of leftovers. I am a wimp when it comes to spice so I left out the red pepper flakes and added a bit more garlic (never too much garlic!). I also added a tiny bit more tomato paste (1. to thicken it a little more and 2. what else can I do with this tomato paste?). Made some steamed broccoli for some greens on the side. Will definitely be making again for a yummy comfort meal 🙂

    1. I opened a can of tomato paste and took a tablespoon out. Then I used the rest to make tomato sauce by putting the paste into a 2 cup measuring cup adding just slightly a cup of water and using a whip to mix until you have a sauce. If you want to make it like the canned add a pinch of sugar.
      I normally add about 2/3 of a cup of heavy cream and enough shredded Parmesan cheese to thicken it till it’s actually Country style Rigatoni.
      For a slightly different taste a LESS than a pinch of 5 Chinese spices while cooking the sausage or when you put the other spices in.

    1. Stephanie, I’m not a fan of tomato chunks either, anytime I see a recipe with tomato chunks I always buy tomato puree works great!

  7. Is there a way to make this dish non spicy dish? I have had it spicy and it was delicious, but the group I am making it for don’t have a high tolerance.

  8. Followed the recipe to a T and it was DELICIOUS!! Used hot italian sausage which made the recipe.
    Thanks for the yummy pasta comfort recipe!

  9. This is a quick & delicious sauce! It is thick, so instead of frying the sausage like ground beef, I pinched off pieces a bit larger as I was putting them in with the onion. I think it really showcases the sausage against the thick sauce. I made exactly as directed but next time I will double the recipe. It’s a 30-minute meal that tastes like it simmered all day! Thank you for the delish alternative to standard meat sauce!

  10. Very good but a little spicy for me. I used 3 hot sausages and two mild. I will make it again but only use mild or sweet sausage

  11. Made this for my in-laws and husband. Everyone loved it. We live in a very Italian city here in Upstate NY, so we all know good Italian food. This was super easy and really flavorful!

  12. Delicious! I really enjoyed it. I would’ve liked a bit more sauce but that’s an easy fix. We added mushrooms and red peppers and it was amazing.

  13. Family loves this very tasty pasta dish.. I cook it pretty often and it is sooo easy💕 Where has Italian sausage been all my life?

  14. I turned this recipe into an instant pot recipe. Same incredients but added 24 oz of water (for the IP requirements/pasta cooking) and cooked on manual pressure for 8 min. I’m camping and didn’t want to wash another pot or stand over the stove. It was good, I’m glad it was easy enough to convert

  15. My husband and Korean mother both LOVED this dish, and my mother usually steers away from Italian. The spiciness helped cut the creaminess of the sauce, making for one perfectly balanced meal. Thank you for this excellent recipe!

  16. Probably have made this 6 times in last year, really tasty. First couple times it was too salty. I only add a pinch of salt as the dish is plenty salty with sausage and Parmesan cheese.

  17. Hi Christin. I cook ALOT and must say this was a yummy recipe. I have other pasta recipes that are equally delicious, however it’s nice to try something new . I used hot Italian sausages and Fire Roasted tomatoes to give it a little more kick and I’m glad I did…super result!

  18. This is the best darn thing I have ever made and that I have ever eaten and my boyfriend loves it so much! I use both mild and spicy sausage and a sweet yellow onion, but omg i make this so often cuz the boyfriend requests it so much!! I wish that i could give 10 stars!! THANK YOU for this recipe!!!!!!!

  19. I came across this recipe when I googled. Sounded good so I made it. It was yum and the spicy sausage added flavour. My hubby loved it too. After a week of extremly high temperatures here in Oz and a cool change today we felt like some pasta. Will be making again. Thanks 😊

  20. Made this a number of times now but with greek yogurt instead of cream and I have to say this has become one of my favourite meals. Everyone I’ve made it for have really enjoyed it as well. In fact I am making it again today. Can’t wait till it’s ready!!! Thanks

  21. This recipe is very good. I sautéed the onions & garlic after I browned the sausage. Then put sausage back in pan and added tomato paste then a cup of white wine & let it boil a couple minutes. Then put the tomatoes & sauce in.

    1. Leftovers could be frozen if you didn’t mix it with the pasta. Cooked pasta doesn’t reheat very well.

  22. This is an excellent dish. Making it the second time tonight for my daughter whose home from college on spring break. I used a combination of mild and spicy sausage.

  23. Made this for the first time tonight and it was OUTSTANDING! Puts any Italian restaurant to shame. Will definitely make again…..really soon. 🙂

  24. I love this recipe! It reminds me of my favorite dish from my favorite Italian restaurant. I added one package of diced pancetta and it was heavenly. I cooked that first and removed it, then cooked the onions and sausage in the grease from the pancetta and added it back after the meat was browned. Highly recommend trying that 🙂

  25. Made a double batch of this tonight for dinner. Followed the recipe exactly. Perfect for a cool fall evening. My husband and I both loved it. He told me he already can’t wait for the leftovers!

  26. Just popping by to say I’ve tried probably a dozen recipes off your website, and they’ve never let me down! Keep up the amazing work!!

  27. Sooo good. I chopped up mushrooms and added extra tomatos. Sooo good. Thabk you for the recipe.

  28. Made this tonight. Followed the recipe to a tee. Came out great….was a hit for the whole fam. Tasted just like my favorite dish from bucca did pepper. Thanks for the recipe. Kudos.

  29. I made this dish for supper last night and it was delicious and so easy to make. Definitely one of our favs ?

  30. I wanted to let you know that the comments at our dinner table were along the lines of, “Hot dang, this is *good*!” Thanks for such a tasty, easy recipe for my Sunday, when about all I had in the fridge was a package of bulk sausage, lol 😉

  31. I just made this and it was very very good. I didn’t have a can of tomatoes so I used a can of Rotel instead. Hubby and I both agreed, for us, next time we will use ground chuck, and maybe a tspn of basil rather than 1/2. I really have no complaints as it was truly a really good and pretty easy recipe. It makes quite a bit so make sure you have a big serving bowl ! This is a keeper. Thank you!

  32. I made this pasta tonight for my family. I used hot Italian sausage and it turned out delicious. I will definately be making this one again. Thanks for the recipe.

  33. This was delicious! Next time I might cut back just a touch on the red pepper flakes but it was so yummy.

  34. This looks so comforting and delicious, Christin! I love the spicy kick from the sausage and the extra richness from the cream sounds SO SO good!!:)

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