Our Italian Sausage and Orecchiette in Creamy Tomato Sauce recipe features savory Italian sausage, orecchiette pasta, and a rich sauce made from San Marzano tomatoes and heavy cream, then we finish it with fresh spinach and Parmesan for the perfect one-pot dinner.

Table of contents
Why You’ll Love this Italian Sausage and Orecchiette in Creamy Tomato Sauce
If you’re looking for a pasta dish option that is delicious, quick, and easy, this Italian Sausage and Orecchiette in Creamy Tomato Sauce recipe is a must. In just 30 minutes, you can enjoy a rich, homemade creamy dish that’s bursting with flavor.
One-Pot Dinner: You won’t have to worry about cleaning up a bunch of dishes with this one-pot meal!
Quick and Easy: Everyone wants a nutritious and tasty dinner without spending hours in the kitchen! This one’s perfect for busy weeknights with minimal prep time.
Perfect Flavor Combo: The combination of Italian sausage, high-quality tomatoes, and creamy sauce creates a comforting experience.
Crowd Favorite: A dish everyone will love for any occasion!

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Ingredients
- Italian Sausage – season with red pepper flakes for a kick
- Red pepper flakes – optional
- Olive oil
- Yellow onion, diced
- Garlic, minced
- Orecchiette pasta
- Dry white wine – sauvignon blanc, pinot gris, chardonnay
- 1 28-oz can San Marzano tomatoes – or another high-quality canned tomato from Italy or California
- Italian seasoning
- Thyme – dried or fresh
- Heavy cream – to give the sauce a rich creaminess
- Spinach – for a pop of color and delicious nutrients
- Salt – measure with your heart. We prefer non-iodized kosher or sea salt.
- Parmesan – finish this pasta with freshly grated parmesan
How to Make Italian Sausage and Orecchiette in Creamy Tomato Sauce
Step 1: Start by browning the Italian sausage in a large sauté pan over medium-high heat until completely cooked through. Season with red pepper flakes, if desired. Then, remove the sausage to a separate plate.

Step 2: Start a pot of boiling water with salt and cook the pasta according to the package instructions.
Step 3: Then, add the olive oil to the same pan. Once hot, add the diced onion and sauté until translucent, about 4-5 minutes.
Step 4: Once the onions are translucent, add the minced garlic, oregano, basil, and thyme. Sauté for another minute until the garlic is fragrant. Then, pour in the dry white wine and let it simmer for 3-4 minutes.

Step 5: Add the can of San Marzano tomatoes, crushing them with your hands before placing them in the pan. Add a generous pinch of salt and let the sauce simmer for about 5 minutes. Then, pour the sauce into a food processor or blender and blend until smooth. Return the sauce to the pan.



Step 6: Stir in the heavy cream and cooked sausage. Then, add the cooked pasta and spinach to the sauce, stirring until the spinach is wilted. Season to taste with salt.
Top with freshly grated Parmesan cheese and serve.

Tools You’ll Need
Food Processor/Blender – you’ll need one of these to blend the sauce to make it nice and smooth.
Large Saute Pan – this one-pot meal requires a large sauté pan.
Zester/Grater – to grate that block of fresh Parm, I use this one every day.

Tips and Variations
Sausage: When it comes to the sausage, it’s really up to personal preference which type you’d like to use. I like to use hot Italian sausage or mild, and then add some crushed red pepper flakes.
Tomatoes: Using high-quality canned tomatoes, such as certified San Marzano tomatoes, makes or breaks the sauce. Some brands I recommend are Cento, REGA, and San Merican Tomatoes.
Cream: For a creamy tomato pasta sauce without cream, swap the heavy cream for coconut milk.
Pasta: Orecchiette is my favorite pasta for this dish, but use any small/medium-sized pasta shape you’d like or have on hand.

Storage: Store in the refrigerator for up to 4 days. Note- the pasta will absorb the sauce the longer it sits, so if you plan on making it ahead of time, wait to combine the noodles with the sauce until ready to serve.
Recipe Card
Italian Sausage and Orecchiette in Creamy Tomato Sauce
Course: DinnerDifficulty: Easy6
servings30
minutesIngredients
1 lb Italian Sausage
1 Tbsp olive oil
1 yellow onion, diced
4 cloves garlic, minced
1 lb orecchiette pasta
3/4 cup dry white wine
1 28oz can San Marzano tomatoes
2 tsp Italian seasoning
1 tsp thyme
1 cup heavy cream
2 handfuls of spinach
Salt
Freshly grated Parmesan
Directions
- Start by browning the Italian sausage in a large sauté pan over medium-high heat until completely cooked through. Season with red pepper flakes, if desired. Then, remove the sausage to a separate plate.
- Start a pot of boiling water with salt and cook the pasta according to the package instructions.
- Then, add the olive oil to the same pan. Once hot, add the diced onion and sauté until translucent, about 4-5 minutes.
- Once the onions are translucent, add the minced garlic, oregano, basil, and thyme. Sauté for another minute until the garlic is fragrant. Then, pour in the dry white wine and let it simmer for 3-4 minutes.
- Add the can of San Marzano tomatoes, crushing them with your hands before placing them in the pan. Add a generous pinch of salt and let the sauce simmer for about 5 minutes. Then, pour the sauce into a food processor or blender and blend until smooth. Return the sauce to the pan.
- Stir in the heavy cream and cooked sausage. Then, add the cooked pasta and spinach to the sauce, stirring until the spinach is wilted. Season to taste with salt.
Top with freshly grated Parmesan cheese and serve.
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