Creamy Pesto Pasta with Italian Sausage — 30-Minute Weeknight Dinner

This is a Tuesday night dinner. Thirty minutes, one skillet after the pasta pot, and the kind of sauce that makes everyone quiet at the table — which, with kids around, is its own kind of win.

Why This Recipe Works

• Genuinely 30 minutes. The sausage cooks while the pasta boils. There's no waiting around.
• One pan after the pasta pot. The sauce comes together in the same skillet start to finish.
• The sauce is hard to mess up. Cream, pesto, and pasta water do the heavy lifting — no roux, no whisking, no timing anxiety.
• Kid-friendly without being boring. The pesto flavor is there but mellowed by the cream. Leave out the red pepper flakes and it's mild enough for picky eaters.
• Flexible. Works with whatever pasta shape you have, and the protein is easy to swap.

Ingredients

• 1 lb rigatoni or penne pasta
• 1 lb mild Italian sausage, casings removed
• 3 cloves garlic, minced
• 1/2 cup basil pesto, store-bought
• 3/4 cup heavy cream
• 1/2 cup reserved pasta water
• 1/2 cup grated Parmesan cheese, plus more for serving
• 1/2 teaspoon crushed red pepper flakes (optional)
• Salt and black pepper to taste
• 1 tablespoon olive oil
• Fresh basil leaves for garnish (optional)

Instructions

1. Bring a large pot of salted water to a boil. Cook pasta according to package directions until al dente. Before draining, scoop out 1/2 cup of pasta water and set aside. Drain and set pasta aside.
2. While pasta cooks, heat olive oil in a large skillet over medium-high heat. Add sausage and break it into crumbles with a wooden spoon. Cook 6-8 minutes until browned and cooked through.
3. Reduce heat to medium. Add garlic to the sausage and cook 60 seconds, stirring constantly — it goes from fragrant to burnt fast at this temp.
4. Pour in the heavy cream and stir to combine. Let it simmer 2-3 minutes until it thickens slightly.
5. Remove the pan from heat and stir in the pesto. Adding pesto off the heat keeps it bright green and prevents it from turning bitter.
6. Add the drained pasta to the skillet and toss to coat. Pour in pasta water a splash at a time until the sauce reaches a consistency you like — silky and just loose enough to coat every piece.
7. Stir in Parmesan, taste for salt and pepper, and add red pepper flakes if using. Serve immediately with extra Parmesan on top and fresh basil if you have it.

Tips and Substitutions

• Swap the sausage. Hot Italian sausage works if your family runs spicy. Ground turkey or chicken sausage both work too — just add an extra pinch of salt since they're leaner and less seasoned.
• Make it vegetarian. Skip the sausage and add a can of drained white beans and a handful of halved cherry tomatoes. Still a full, satisfying bowl.
• Lighten the sauce. Half-and-half works in place of heavy cream. The sauce will be a little thinner, but still good — just don't skip the pasta water.
• Add vegetables. A few handfuls of baby spinach stirred in at the end wilt down fast and disappear into the sauce. Frozen peas work the same way — just toss them in straight from the bag.
• Leftovers. This reheats well with a splash of water or cream to loosen the sauce. The pasta absorbs a lot overnight, so don't skip the liquid when warming it back up.

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