Spicy Sausage Fettuccine

Hot Italian sausage does all the work here – no need for a ton of spices when the meat’s already seasoned. This comes together in under 40 minutes and uses one pan for the sauce.

June Arthurs
March 18, 2026
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Ingredients (6 servings)

  • 1 lb ground hot Italian sausage
  • 1 Tbsp olive oil
  • 1/2 medium onion, diced
  • 5 cloves garlic, minced
  • 1 Tbsp tomato paste
  • 1 can (28 oz) crushed tomatoes
  • 1/2 tsp dried oregano
  • 1/2 tsp dried parsley
  • 1/4 tsp Diamond Crystal kosher salt
  • 1/8 tsp ground black pepper
  • 16 oz dried fettuccine
  • 1/2 cup grated Parmesan (or Pecorino)
  • 6-8 fresh basil leaves

Brown the Sausage

Heat a large pan over medium heat.

Add the 1 lb of ground Italian sausage and break it up with a wooden spoon as it cooks.

Cook for ~10 minutes, stirring occasionally, until browned on all sides and cooked through.

Transfer to a paper towel-lined plate to drain; set aside.

Cook the Aromatics

Add the 1 Tbsp of olive oil to the same pan and set it back on the stove over medium-low heat.

Add the 1/2 diced onion and cook for ~5-6 minutes, stirring occasionally.

Add the 5 cloves of minced garlic and cook for 1 minute more.

Add Tomato Paste and Build the Sauce

Stir in the 1 Tbsp of tomato paste and break it up into smaller globs so it coats the onion and garlic.

Cook for ~2 minutes, stirring frequently.

The paste will darken slightly and smell sweeter.

Pour in the 28 oz can of crushed tomatoes, then add the 1/2 tsp oregano, 1/2 tsp parsley, 1/4 tsp salt, and 1/8 tsp pepper.

Stir everything together, then reduce heat to low.

Cover the pan mostly – leave a crack for steam to escape – and let simmer until thickened to your liking, stirring occasionally.

Cook the Pasta and Combine

While the sauce simmers, bring a large pot of salted water to a boil.

Add the 16 oz of fettuccine and cook according to package directions.

Drain the pasta and return it to the pot.

Taste the sauce and adjust salt and pepper if needed, then pour it into the pot with the pasta.

Stir until the fettuccine is evenly coated.

Stir in the 1/2 cup of grated Parmesan and the 6-8 fresh basil leaves (tear them if they’re large).

Portion out to serve with extra Parmesan on the side.

Spicy Sausage Fettuccine

Hot Italian sausage does all the work here – no need for a ton of spices when the meat’s already seasoned. This comes together in under 40 minutes and uses one pan for the sauce.
prep time15 minutes
cook time30 minutes
total time45 minutes
Print Recipe

Ingredients

Ingredients (6 servings)

  • 1 lb ground hot Italian sausage
  • 1 Tbsp olive oil
  • 1/2 medium onion, diced
  • 5 cloves garlic, minced
  • 1 Tbsp tomato paste
  • 1 can crushed tomatoes, 28 oz
  • 1/2 tsp dried oregano
  • 1/2 tsp dried parsley
  • 1/4 tsp Diamond Crystal kosher salt
  • 1/8 tsp ground black pepper
  • 16 oz dried fettuccine
  • 1/2 cup grated Parmesan, or Pecorino
  • 6-8 fresh basil leaves

Instructions

  • Heat a large pan over medium heat. Add ground sausage and break apart with a wooden spoon, cooking for 10 minutes until browned. Transfer to a paper towel-lined plate.
  • Add olive oil to the same pan over medium-low heat. Add diced onion and cook for 5-6 minutes, stirring occasionally.
  • Add minced garlic and cook for 1 minute more.
  • Stir in tomato paste and cook for 2 minutes, stirring frequently, until darkened and fragrant.
  • Pour in crushed tomatoes and add oregano, parsley, salt, and pepper. Stir well.
  • Reduce heat to low, cover partially with a crack for steam to escape, and simmer until thickened, stirring occasionally.
  • While sauce simmers, bring a large pot of salted water to a boil. Add fettuccine and cook according to package directions.
  • Drain pasta and return to pot. Taste sauce and adjust seasoning if needed.
  • Pour sauce into pasta pot and stir until evenly coated.
  • Stir in grated Parmesan and fresh basil leaves, tearing large leaves if needed.
  • Serve with extra Parmesan on the side.