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Italian Sausage Rigatoni with Spicy Cream Sauce

Sausage with Rigatoni in Spicy Cream Sauce is pure comfort food and makes an easy and delicious weeknight meal. This recipe strikes a delightful balance between the acidity of the tomatoes and the indulgent creaminess of the sauce.

Italian Sausage Rigatoni with Spicy Cream Sauce in a bowl.

The flavor starts with onion and garlic which are sauteed with the sausage for maximum flavor.

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.

Pasta coated in sauce in serving bowl.

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 pasta dish, I think- I don’t cook rigatoni nearly enough! I love the chewiness and substance it has. This dish is the epitome of comfort food!

Close-up of Italian Sausage Rigatoni with Spicy Cream Sauce.

How To Serve Italian Sausage Rigatoni with Spicy Cream Sauce

This spicy sausage rigatoni dish tastes great topped with some chopped fresh basil, garlic bread, and a garden salad with Creamy Italian Dressing.


  • Use penne or ziti in place of rigatoni.
  • Use turkey sausage in place of Italian sausage.
  • Leave the red pepepr flakes out if you don’t want it spicy.

Never miss a recipe. Follow Spicy Southern Kitchen on Pinterest and Instagram.

Italian Sausage Rigatoni with Spicy Cream Sauce in bowl.

More Easy Pasta Recipes

Watch the short video below to see how easy this recipe is to make.

Sausage Rigatoni with Spicy Tomato Cream Sauce

Italian Sausage Rigatoni with Spicy Cream Sauce

Italian Sausage Rigatoni in Spicy Cream Sauce makes an easy weeknight meal. The sauce has the perfect balance between tomatoes and cream.
PREP: 5 minutes
COOK: 25 minutes
TOTAL: 30 minutes


  • 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.


Nutritional info is provided as an estimate only and will vary based on brands of products used. Not to be used for specific dietary needs.


Calories: 754kcal | Carbohydrates: 62g | Protein: 27g | Fat: 44g | Saturated Fat: 18g | Polyunsaturated Fat: 5g | Monounsaturated Fat: 18g | Cholesterol: 105mg | Sodium: 1444mg | Potassium: 791mg | Fiber: 4g | Sugar: 7g | Vitamin A: 839IU | Vitamin C: 16mg | Calcium: 180mg | Iron: 4mg
Author: Christin Mahrlig
Course: Main Course
Cuisine: American
Keyword: pasta, sausage

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Originally posted September 6, 2015.

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123 thoughts on “Italian Sausage Rigatoni with Spicy Cream Sauce”

  1. 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.

  2. 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.

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

  4. Katherine Ratcliffe

    I don’t have any heavy cream or greek yogurt, does anyone know of any good substitutes?

  5. 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. Norma Buccitelli

      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!

  6. 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.

  7. Monster Foodies

    Wow, looks amazing. I have always enjoyed the combination of rigatoni with italian sausage. I can’t wait to try it!

  8. Paige Parker

    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. Melissa Torres

    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. Katy Harewood

    Absolutely delicious!! I used just pork sausages and added a bit more herbs to compensate but really great dish!

  14. 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?

  15. 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

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