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

  1. Yum! I didn’t have heavy whipping cream so just used skim milk and pasta water and turned out so good. Very easy and fast to make too.

  2. Yum! This has become our favorite pasta dish. The recipe looked “too easy” to be really good but I was so wrong! We like to sauté mushrooms (on the side – add at the very end). This freezes and reheats beautifully and has gone on many RV excursions.

    Another note: The first time I made this, I only had Turkey Italian Sausage and we loved it so much, we haven’t even tried any other sausage.

    Thanks for this recipe.

  3. This was really delicious, a great recipe! I basically followed the directions, except for adding 1 tsp. red pepper flakes instead of a half, didn’t drain the sausage fat because there wasn’t that much, and rather than putting cooked pasta in a bowl and adding sauce, I just added the pasta to the sauce as one other commenter said. I have a large saucepan with high sides that I got for this kind of dish, and it worked out perfectly. Definitely will be making this one again!

  4. Quick and simple to make. Absolutely delicious. The family loved it. I will add mushrooms next time.

  5. I’ve made this several times. It is one of my favorite recipes. It is so easy and flavorful. I live alone but make the full recipe of sauce and freeze it in individual servings. I take one out when I want it and then make my rigatoni. It’s delicious every time.

  6. I’ve made this meal like 6 times, definitely one of my Pinterest faves! I use spicy ground sausage for an extra kick

  7. This recipe is the best! I love this meal and everyone I’ve cooked it for has loved it. It is flavorful and filling. You can tweak the spiciness or leave as is. Perfect!!

  8. Fantastic recipe! I used Publix Hot Italian Sausage (fresh bulk sausage – not in casings). everyone loved it….no leftovers. Will make this again soon!

  9. I fell in love with a pasta dish years ago. The restaurant that carried the dish closed. So for years I’ve searched a dish similar to it. I then stumbled across this one and was amazed not only how close it was but how simple of a recipe it was. The flavor is amazing and my whole family loves it. It became not only a staple in my house but my sister and her kids loved it so much it’s now a staple in they’re house as well. If you need a tasty meal in a pinch this is it.

  10. Tried this recipe tonight and it was so good. I substituted the Italian Sausage for Italian Turkey Sausage and instead of the can of diced tomatoes, can of tomato sauce and tomato paste I just used Ragu Chunky Tomato sauce. Very good. I will definitely keep this in rotation.

  11. This recipe is so simple, with not a lot of ingredients, yet SO flavourful. This is a go to in my house. My husband, picky toddler and 10 month old devour their helpings and always ask for more. It’s so easy to make but tastes gourmet. I always top it with extra parm and some fresh parsley. So glad I found this recipe!

  12. 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?

  13. David J Kershner

    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.

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