Orecchiette Pasta with Italian Sausage


Orecchiette pasta with Italian sausage is one of our go to meals for a special occasion or when we want a nice, hearty bowl of pasta. It’s also so easy to make, which is such a bonus! A warm bowl of orecchiette pasta, a little spice from the sausage, and finished with a creamy tomato goodness. Oh, and don’t forget the parmesan and parsley of course!

What do you need to make the spinach and mushroom bowtie pasta?

  • Spicy Italian Sausage- We use these Belcampo spicy Italian sausages (you can use the code RADIANCE10 for 10% off on their website) but feel free to whatever you like. You can also do a mild one if you don’t like spice.
  • Olive oilThere is just nothing like some good quality olive oil. I use a ton of olive oil, because it’s one of my favorite things! Adds such a nice light yet rich flavor to this sausage pasta dish!
  • Garlic- Fresh garlic is 100% ideal here. There’s nothing like fresh garlic!
  • Shallot- Shallot is preferred here. If you have to, you could substitute with white onion, but shallot really brings out the best flavor.
  • Canned San Marzano tomatoes- You can use either whole peeled or crushed. We love the whole so you crush them yourself and have little chunks, but both work great! San Marzano are ideal!
  • Heavy cream- This adds the best rich creaminess to the sauce. You could substitute with whole milk or half and half if that’s what you have but heavy cream will yield the best result.
  • Orecchiette pasta- Orecchiette is just so good and one of my favorite pasta shapes. It just pairs with this recipe really well but feel free to use any shape or variety! Whole wheat, white, chickpea, etc.
  • Parmesan– Why is parmesan SO GOOD? Cheese is essential to my living. You can use fresh parmesan, like we did, and grate it yourself. You can also buy the already grated to save even more time. Pecorino romano would work wonderfully too.
  • Parsley– Adds the perfect fresh green touch to the top! You could also use basil, but we prefer parsley for this orecchiette pasta with Italian sausage.
Thomas (or man) wearing apron holding pan filled with Orecchiette Pasta with Italian Sausage with kitchen in the background.

Tips for making it:

  • To save time you can take a few shortcuts. You can buy already grated garlic and already shredded parmesan for quick alternatives.
  • Make sure you add the parmesan right onto the fresh pasta when you pour it into the pan with the rest of the ingredients. This ensures that the parmesan sticks onto the spinach and mushroom pasta and just gives it a great distribution!
  • You can use substitutions but I wouldn’t recommend it. The way this recipe is made is perfect and if you want the best authentic result, I wouldn’t change a thing!
Close up of Orecchiette Pasta with Italian Sausage with a pan.

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Alright, let’s get to making the recipe! Enjoy!

Print Recipe
4.34 from 3 votes

Orecchiette Pasta with Italian Sausage

Orecchiette pasta with Italian sausage is one of our go to meals for a special occasion or when we want a nice, hearty bowl of pasta. It's also so easy to make, which is such a bonus! A warm bowl of orecchiette pasta, a little spice from the sausage, and finished with a creamy tomato goodness. Oh, and don't forget the parmesan and parsley of course!
Cook Time30 minutes
Course: Main Course
Cuisine: Italian
Keyword: easy dinner, orecchiette pasta, pasta, sausage pasta
Servings: 4


  • 4 spicy Italian sausages
  • 2 tbsp olive oil
  • 1 tbsp fresh garlic finely chopped
  • ¼ cup shallot finely chopped
  • 1 28oz can whole peeled tomatoes San Marzano
  • ¼ cup heavy cream
  • 1 tsp sea salt
  • ½ tsp pepper
  • 6-8 oz orecchiette pasta
  • ¼-⅓ cup fresh parmesan grated
  • fresh parsley for sprinkling


  • In a medium stockpot, add salt and boil pasta. Cook until desired doneness.
  • Meanwhile, in a large saucepan, heat about 1 tbsp olive oil on medium high heat.
  • Remove sausage casings and crumble into olive oil. Break sausage into pieces and cook until cooked through. Remove from pan, and set aside in a separate bowl.
  • In the same pan, add another tbsp of olive oil. Add in your fresh garlic and shallots. Cook on medium heat for a few minutes until the shallots start to become translucent.
  • Add in the full 28oz can of tomatoes including the liquid. Break apart the tomatoes to create a sauce. Season with ½ tsp sea salt and pepper. Cook for a few more minutes and break down. You can leave some chunks of tomatoes.
  • Add in the heavy cream and stir until combined. Pour back in the sausage and mix together.
  • Drain the pasta when it's done, and pour into the sauce mixture. Reserve about ⅓ cup of the pasta water and add in as well. Test and add additional ¼- ½ tsp sea salt if needed.
  • Sprinkle in the fresh parmesan over the pasta before mixing. Mix until the sauce is well coated over the pasta.
  • Serve with a sprinkle of fresh parsley and parmesan!


For Storing: Store in an airtight container in the fridge for 3-4 days.



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  8. Oh my goodness! the [Orecchiette] Pasta with Italian Sausage was amazing! I have celiac so I had to use Explore Cuisine Red Lentil Penne Pasta. Also, I do not eat dairy so I substituted cashew milk for the cream and the result was excellent. This the kind of meal that is great for a dinner party. I plan to make it again and again!

    • Hi Pam!! Ah I’m so happy to hear you loved it! And I’m so glad the substitutions worked, so good to know! Thanks for making our recipe 🙂

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