Creamy Italian Sausage Pasta

This Creamy Italian Sausage Pasta is one of those easy pasta recipes that comes together with just a handful of ingredients but delivers plenty of flavor. Italian sausage and mushrooms are cooked together and finished with a creamy sauce, then tossed with pasta and Parmesan cheese for a comforting meal the whole family will love.

We make this Italian sausage pasta often at home, especially when we want something simple but a little different. It is rich and creamy without requiring a long list of ingredients, making it an easy choice for a weeknight dinner and the kind of comfort food everyone enjoys.

Mushrooms have always had a special place in my family. My father loved going mushroom hunting and was very knowledgeable about fresh mushrooms. Thanks to him, I learned how to recognize and safely use mushrooms in cooking, as well as how to turn them into delicious dishes that taste like home.

This recipe came from my own search for a pasta dish that was simple, flavorful, and a little different from the usual. Sometimes you open the refrigerator and have no idea what to make for dinner, and that is when you have to get creative!

This is my creamy take on pasta alla boscaiola, a classic Italian combination of pasta, mushrooms, and sausage. It is easy, comforting, and full of the kind of flavor that makes you want to go back for another bowl.

Ingredients for Creamy Italian Sausage Pasta

Here is everything you need to make this creamy and flavorful Italian sausage pasta:

• Italian sausage
• Mixed mushrooms, sliced
• 1 shallot, finely chopped
• Garlic
• Cream cheese
• Parmesan cheese, freshly grated
• Extra virgin olive oil
• Gemelli Pasta

Ingredient Notes

• Italian sausage: Italian sausage makes this recipe especially flavorful and convenient. If you buy Italian sausage links, simply remove the casing and use the sausage meat. You can use mild or spicy Italian sausage depending on how much heat you like.
• Mushrooms: A combination of mushrooms works beautifully in this recipe. Cremini, baby bella, white button, portobello, and porcini mushrooms are all good choices. Slice the mushrooms fairly thin so they cook evenly.
• Cream cheese: I use cream cheese to make the sauce creamy and smooth. It is easy to find in the U.S. and gives the pasta a rich texture without needing a large amount of cream. When adding it to the pan, use some of the hot pasta water to help it melt into a smooth sauce.
• Parmigiano Reggiano: Freshly grated Parmigiano Reggiano gives the sauce extra flavor and helps bring everything together. For the best texture, grate it yourself rather than using pre-shredded cheese.
• Onion: Yellow onion works well here, but you can also use a seasonal green onion or red onion. Red onion will give the finished dish a slightly stronger flavor.

How to Make Creamy Italian Sausage Pasta

Clean and slice the mushrooms

If you are using fresh porcini mushrooms, gently clean them with a soft brush and slice them. For other fresh mushrooms, remove any dirt and debris before slicing. You can wipe them clean with a damp paper towel or quickly rinse them under cold water and dry them thoroughly.

Cook the Italian sausage

Heat a large skillet over medium-high heat and add a drizzle of extra virgin olive oil. Add the finely chopped shallot and cook for 2 to 3 minutes, until softened.

Add the Italian sausage to the skillet and cook over medium-high heat, breaking it up with a wooden spoon as it cooks. Continue cooking for about 8 to 10 minutes, until the sausage is browned and cooked through.

Cook the mushrooms

While the sausage cooks, bring a large pot of salted water to a boil for the pasta.

Once the sausage has started to brown, add the sliced mushrooms to the skillet. Add the garlic clove, cut in half, and sauté the mushrooms over high heat for about 5 minutes.

Season with salt and black pepper. Remove the garlic clove once it has flavored the mushrooms.

Stir the sausage and mushrooms together and continue cooking until everything is well combined.

Make the creamy sauce

Turn off the heat and add the cream cheese directly to the skillet with the sausage and mushrooms.

Cover the skillet with a lid and let it sit for a few minutes. The residual heat and steam will soften the cream cheese, making it easy to combine with the other ingredients.

Meanwhile, cook the gemelli pasta in the boiling salted water according to the package directions, until al dente.

Drain the pasta and add it directly to the skillet with the sausage, mushrooms, and softened cream cheese.

Return the skillet to medium heat and toss everything together. Stir with a wooden spoon as the cream cheese melts completely and coats the pasta, creating a thick and creamy sauce. You should not need to add pasta water. 

The softened cream cheese melts into the hot pasta and sausage mixture on its own, giving the sauce the creamy consistency this dish is meant to have.

Once the pasta is coated in the creamy sauce, your Creamy Italian Sausage Pasta is ready to serve.

For serving, sprinkle with freshly chopped parsley and grated Parmesan cheese.

How to Store and Reheat Creamy Italian Sausage Pasta

This creamy Italian sausage pasta is best served immediately, while the sauce is hot and creamy, but you can refrigerate leftovers and reheat them the next day.

Store the pasta in an airtight container in the refrigerator and use it within 2 to 3 days.

To reheat, place the pasta in a skillet over low to medium-low heat and warm it slowly, stirring occasionally. The cream cheese sauce will loosen as it heats. If the pasta seems a little dry, you can add a small splash of milk while reheating.

I don’t recommend freezing this pasta. The cream cheese sauce can change texture after freezing and thawing, so this dish is much better when made fresh.