This sausage Alfredo pasta has the most delicious, silky-smooth sauce made with butter, Parmesan cheese, and a splash of starchy pasta water. No cream needed!
My family loves classic fettuccine Alfredo, and this version with Italian sausage is right at the top of our favorites list. If you’ve seen my chicken Alfredo recipe, you already know I skip the cream. Instead, our Alfredo sauce comes together with butter, Parmesan, and pasta water. It’s every bit as creamy, just a little lighter, and not at all heavy or goopy.
The sausage adds so much flavor to this pasta. You’ll brown it in the same skillet you use to make the sauce, so all it soaks up all those flavorful drippings, which means extra flavor, and as a bonus, fewer dishes to clean!
Key Ingredients
- Italian Sausage: Choose mild or spicy sausage, depending on what you love. Our family usually sticks with mild, but if you like a little kick, go for spicy! I also use Italian sausage when making this sausage minestrone (it’s so good!).
- Spinach: I love the pop of green from baby spinach here. It wilts right into the sauce for a fresh, vibrant finish. Baby kale works just as well if that’s what you have on hand.
- Fettuccine: That’s the traditional choice, but you can substitute what you have on hand. Spaghetti, linguine, or even short pasta like farfalle are all great options. Be sure to save a little pasta cooking water before draining. It’s the secret to a smooth, glossy sauce that clings to every strand. To make this really special, try homemade pasta!
- Parmesan: Use a good-quality parmesan for this recipe, and grate it finely. I love Parmigiano-Reggiano and find that it melts the best.
- Butter: I use salted butter, but unsalted is fine (adjust the pasta to taste with a bit of extra salt).
Find the full recipe with measurements below.
How to Make Sausage Fettuccine
Tip 1: Brown the sausage. This sausage Alfredo pasta comes together in about 20 minutes, and the first step is browning the sausage. Do this in the same skillet you’ll use to toss the pasta and sauce. Once browned, you’ll have bits of sausage stuck to the pan, along with some rendered fat that ultimately adds so much flavor to your sauce.
Tip 2: Make the sauce. You’ll make the sauce right in the skillet with the browned sausage. Add everything (cooked fettuccine, finely grated parmesan, butter, spinach, and some starchy pasta cooking water), then use tongs to toss everything around the skillet until the butter and cheese melt down into a smooth and silky sauce. It’s not all that different from when we make our favorite cacio e pepe recipe.
More Easy Pasta Recipes
Sausage Alfredo Pasta
- PREP
- COOK
- TOTAL
This fettuccine is quick, easy, and incredibly delicious thanks to Italian sausage. For the best results, use real Parmigiano-Reggiano and finely grate it yourself (it melts into the sauce better). When cooking your pasta, make sure you salt it well to taste salty like the sea (assume 1 tablespoon of salt for 3 quarts of water). And don’t forget to reserve some pasta cooking water before draining the pasta. It’s the pasta water that brings the sauce together.
You Will Need
6 ounces Italian sausage, casings removed, use hot or mild sausage
1 pound fettuccine
4 ounces Parmigiano-Reggiano, finely grated, about 2 cups, plus extra for serving
5 tablespoons butter, cut into 5 pieces
4 to 5 cups packed baby spinach leaves
Salt and fresh ground black pepper
Directions
1Cook sausage: Add the sausage to a wide skillet with a drizzle of olive oil over medium-low heat. Cook, breaking up the sausage with a wooden spoon until crispy, about 10 minutes. (While the sausage cooks, move on to cooking the pasta.)
2Cook fettuccine: Meanwhile, bring 3 quarts of water to a boil in a large pot. Add one tablespoon of salt and the fettuccine. Cook, stirring once or twice, for 1 minute less than the suggested cooking time on the package. The pasta finishes cooking when making the sauce. Reserve 1 ½ cups of the cooking water, then drain the pasta.
3Make the sauce: Add parmesan cheese, butter, spinach, 1 cup of reserved cooking water, and the drained pasta to the skillet with the cooked sausage. Set the skillet over low heat. Use tongs to toss the fettuccine, butter, and cheese around the pan for one minute. Take the pan off the heat, then cover the skillet with a lid. Leave for one minute.
4Uncover the skillet and toss the pasta a few more times in the sauce. If the pasta looks dry, add a splash of more pasta water. If it looks wet, don’t worry, the pasta absorbs some the extra moisture as it cools. Serve fettuccine with a few grinds of pepper and a sprinkle of extra parmesan cheese over the top.
Adam and Joanne's Tips
- Leftovers: Store leftovers tightly covered in the refrigerator for up to a day. As the pasta sits, it soaks up the sauce so while leftovers taste good, you’ll miss some of the velvety butter cheese sauce. When reheating, add a splash of water to thin the sauce a little.
- The nutrition facts provided below are estimates.
Interestingly, the Italian way to make Alfredo is just butter and Parmesan Cheese. When I was a kid, I would make spaghetti and mix in only butter and Parmesan Cheese, never knowing I was making authentic Alfredo. I will have to try it with Italian Sausage. Can’t wait! My son will love it, too. The two of us are the huge pasta eaters in the house. Thank you, so much, for all the great ideas!!
Hi Ally, We are sorry that you did not enjoy the recipe. It sounds like your sauce didn’t come together to be as silky and luxurious as ours? This recipe is not for the more American-style thick Alfredo sauces (thicker white sauce), and instead is a lighter cream-free sauce made using the starchy water from cooking the pasta.
Thank you for sharing this awesome recipe. It was a major hit at our house. The sauce was delectable! How fun to learn how to use pasta water to make a more “authentically Italian” dish. We didn’t have spinach, but we did have steamed broccoli and cherry tomatoes. They were fun additions. Scrumptious!
SO GOOD! and Easy! Thank you!
All of your recipes look delicious. My granddaughter has recently decided to go the vegetarian route, and I believe she’Ll love everything.Thanks for sharing!
We just made your Sausage Alfredo Pasta. Delicious. Love your recipes. Had a pic
So happy you tried it! Thanks for coming back, Angela!
Quick to make and very delicious! Already cooked it two times!
Adding mushrooms when frying the sausages is recommendable too 😉
Just tried this. Very good! Hubby was trying to steal it from the pan! 🙂 Going on the Repeat List. We will probably up the amount of sausage next time, tho. Other than that, we’re happy!