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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. Please use some pasta water to combine the pasta with the sauce, that’s for literally any pasta/sauce recipe. Kitchen basics.

    1. This is one of my favorite pasta recipes. Don’t let the simplicity fool you. These flavors pack a wallop. ❤️

  2. Very yummy! It’s now a go-to, but I make it ridiculously spicy. Kinda helps w/portion control so the leftovers last longer.

  3. This was very good. Ingredients were well balanced. A little spicy so I would cut back on the red pepper flakes.

  4. This is hands down, our favorite and most-made pasta dish. I honestly didn’t expect it to be as good as it was because the ingredient list is ‘short.’ But oh my!

    My personal changes are that I use Italian Turkey Sausage (rather than regular Italian Sausage) and I also add 8 oz. of sliced, sautéed mushrooms.

    This freezes and reheats beautifully and is a regular stocked item in small freezer tins. We take it on our RV weekends or pull it out on a hectic weeknight.

    Thank you for sharing this wonderful recipe!

  5. Beyond delicious! I use a little more tomato sauce and tomato paste plus I throw in a few sliced sun dried tomatoes. I make this every couple of weeks and it’s a family favorite.

  6. Absolutely my favorite recipe ever! It is soooo yummy and tastes even better a day later! Everyone who has had this LOVES it!

  7. Oh my goodness! This is the best recipe I’ve made yet. Added a bit more sausage and added peas, other than that, this is a keeper.
    Thank you!!

  8. I have made this several times and I’m always amazed at how well it reheats. Nearly every pasta recipe I’ve ever made has been so dry the next day but somehow this works for a week of lunch meal preps. I sub ground chicken (w/ lots of seasoning!) for the sausage and use whatever milk or cream I have on hand and it is always great. I also recommend adding peas to get some green veggies in.

  9. This was so good and easy to make. Highly recommend if you’re a pasta lover. I’m never buying store bought pasta sauce again.

  10. I love this recipe! I want to make it the night before because we are traveling. Any suggestions as how to reheat it?

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