Creamy Tomato Pink Sauce Pasta with Italian Sausage is an easy weeknight meal the whole family will love! It's full of fresh vegetables like red bell pepper, onions, garlic and spinach, with a creamy pink sauce made from canned tomato and half & half. This creamy sausage pasta recipe is one you'll make again and again!
Pasta night is always a favorite, and I always like it to include lots of fresh veggies! This Italian pink sauce pasta is created by mixing red and white, some form of tomato and cream. I've used a basic can of tomato sauce and half & half, but this has a lot of options for variations.
Ingredients & Substitutions
This pink sauce pasta recipe uses just a few simple ingredients with lots of fresh vegetables and flavorful Italian sausage links.
- Italian Sausage - I used 3 mild Italian sausage links for this recipe, but you could also substitute ground bulk sausage, hot Italian sausage if you want it spicy, or use 2 to 4 links depending on how meaty you like it.
- Penne Pasta - Use any short pasta such as rigatoni, ziti, cavatappi, whatever you like!
- Olive Oil - Oil is used to brown up the sausage links after they simmer in water, important for getting that brown delicious caramelization!
- Onion and Red Bell Pepper - The veggie base here gives you some healthy bright color and delicious flavor. I chop the onions small so they blend in, but slice the peppers and then cut the slices in half so they stand out.
- Salt, Pepper, Italian Seasoning - The Italian sausage brings a lot of flavor to the dish on its own, so only a few simple seasonings are needed.
- Garlic - Use fresh and mince it yourself!
- Tomato Sauce and Half & Half - A basic Italian pink sauce is made by combining some form of tomato and cream. I used a can of tomato sauce and half & half, but this is pretty versatile. You could substitute with crushed tomatoes or whole peeled tomatoes and grind or crush them up yourself. You could use this Freezer Marinara Sauce from Garden Tomatoes, or really any spaghetti or marinara sauce you have! In the summer, you could even chop up 2 or 3 fresh tomatoes and cook them into a sauce. Just make sure you use about 2 cups, or a 15oz can, not a large 28oz can. The half & half could also be subbed with heavy cream or whole milk, which will vary the richness of the sauce.
- Fresh Spinach - I love how much fresh spinach you can wilt into a pasta sauce! It gives you beautiful green pops of color, and adds nutrition! You could also use kale, just add it a bit early so it can cook a little longer.
- Parmesan Cheese - The perfect finisher, I like to buy a block of Parmesan cheese and shave off big pieces with a vegetable peeler!
- Garnish with fresh Italian herbs like thyme, oregano, basil, parsley or rosemary.
See recipe card for quantities.
In a large skillet or pot (large enough to toss the entire dish together at the end), simmer the sausages in water until cooked through, about 15 minutes.
At this time, also set a separate pot to boil for the pasta. When boiling, add a pinch of salt, and cook penne until al dente, about 11 to 12 minutes. Pull out about a cup of the starchy cooking water before draining (use a coffee mug or measuring cup). This can be used later to adjust the consistency of the sauce.
Prepare your veggies. Chop your onions small so they blend in. Slice your bell pepper and then cut the slices in half so they are still big enough to stand out. Mince the garlic.
Remove the sausage to a cutting board and pour off the water. You can give the pot a quick rinse. Then return it to the heat, add olive oil, and brown up the outside of the Italian sausage links.
As they are flipped and beginning to brown, you can add the onions and peppers to saute along with them. Season with salt, pepper and Italian seasoning and give them an occasional stir.
Pull the sausages out and slice them on a cutting board, then return them to the cooking veggies to continue caramelizing.
When the veggies and sausage are cooked and getting some nice brown color, add the garlic and cook another minute until fragrant.
Make the creamy pink pasta sauce by adding the canned tomato sauce, half & half, and fresh spinach.
Mix everything together and return it to the heat to simmer about 5 more minutes.
Your sauce is ready to add the pasta and toss well to combine.
You can add a bit of the starchy pasta water that you saved if your sauce gets too thick.
It will continue to thicken, and eventually dry out, the longer you leave it on the burner. You may need to add a bit of the pasta water when you come back to get a second helping.
Serve with fresh Italian herbs and lots of freshly shaved Parmesan cheese. Use a vegetable peeler to get the big shavings!
Substitutions & Variations
This basic creamy pink pasta sauce is really versatile and a great framework to make lots of different dishes by altering the type of pasta, the protein, the veggies and the sauce.
- Spicy Sausage Pasta - If you love spicy, either use hot Italian sausage links, or add a pinch of crushed red pepper flakes when you are sautéing the veggies and sausage.
- Shrimp - Try subbing the protein with fresh or even frozen shrimp. You could also use the homemade meatballs from this Spaghetti and Meatballs recipe as the protein, meal prep extra for the freezer! Chicken or bulk ground Italian sausage would also be good variations.
- The Pink Sauce - An Italian pink sauce pasta can be made out of any form of tomato and cream. This means you can use different tomato products like crushed tomato, fire roasted chopped tomatoes, marinara sauce, or whole peeled San Marzano canned tomatoes chopped. If you have lots of fresh tomatoes, you can chop and use a few in this dish, or try this Creamy Tomato Basil Pasta! You can also vary the half & half, by subbing heavy cream or whole milk.
- Vegetarian and Subbing Veggies- You can leave the Italian sausage out to make this dish vegetarian, but if you do, I'd add some extra veggies! Mushrooms and zucchini would be delicious along with the onions and peppers. You can sub different veggies to make this dish lots of different ways!
Storage & Make Ahead Instructions
Storage - Store extra pasta in the fridge for up to 3 days. Warm in the microwave or on the stovetop. Add a splash of water, milk or half & half to loosen it back up.
Make Ahead - You could also make this entire dish a day in advance. Reheat covered over a low burner on the stove. Again, you will need to add more liquid if doing this such as water or milk.
Freezer - This is not the best dish to freeze! However, buying extra Italian sausage links and freezing them is a great way to always have this meal ready to make! You can thaw them overnight in the fridge or even simmer them when they are still frozen.
What to Serve With Pasta Night
Pasta is always delicious with a big salad and crusty bread! These are our favorite salads and sides with an Italian pasta dinner:
- Italian Mixed Greens Salad with Crispy Prosciutto
- Prosciutto Parmesan Salad with Basil Dressing
- White Bean Bruschetta
- Panzanella Bread Salad with Cherry Tomatoes
If your sauce becomes too thick and your pasta seems dry, you just need to add liquid. Saving a cup or so of the starchy cooking water before draining your pasta is great for adjusting a thick sauce. You can also add a bit of regular water, milk, or more half & half. You may need to do this when reheating leftover pasta.
If your sauce is too thin, just simmer it longer. It will continue to thicken the longer it cooks.
Of course! Any short pasta type like penne, rigatoni, bowtie or medium shells will work great for this recipe. You could even use linguine or fettuccine for something different!
More Favorite Pasta Recipes!
If you made this recipe, I'd love to hear how you liked it! Be sure to leave a star rating or a comment below!
Creamy Tomato Pink Sauce Pasta with Italian Sausage
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- 3 Italian sausage links
- 1 pound penne pasta
- 1 Tablespoon olive oil
- 1 onion chopped
- 1 red bell pepper sliced then cut in half
- ½ teaspoon kosher salt
- 8 grinds fresh black pepper
- ½ teaspoon Italian seasoning
- 4 cloves garlic minced
- 15 oz can tomato sauce
- 1 cup half & half
- 2 handfuls fresh spinach
- ½ cup Parmesan cheese shaved
- Garnish with fresh Italian herbs like thyme, oregano, basil, parsley or rosemary
- In a large skillet or pot large enough to hold the entire pasta dish, simmer the sausage links in water enough to cover them. Medium high heat, about 15 minutes until cooked through.
- Meanwhile, set a separate pot of water to boil. Add a pinch of salt and cook the pasta al dente, about 11 to 12 minutes. Reserve about 1 cup of the starchy pasta cooking water BEFORE DRAINING. Use a measuring cup or coffee mug to pull some out. This can be used if needed to adjust the consistency of the sauce.
- Prep your vegetables while the sausage simmers. Chop onions and slice bell pepper, then cut the slices in half. Mince the garlic.
- Remove the sausage links from the pan and discard the water. Rinse out the pan but no need to wash. Return the pot over medium heat and add the olive oil. Brown the sausage in the pot, about 5 minutes.
- Add the onions and peppers to saute along with the sausage, seasoning them with salt, pepper and Italian seasoning. When the sausage links are browned, remove them to a cutting board. Cut them in slices and return them to the sautéing onions and peppers. About 10 minutes.
- When the veggies are softened and beginning to caramelize, add the garlic and cook another minute until fragrant.
- Add the tomato sauce, half & half, and spinach and simmer about 5 minutes over medium to medium low heat until the spinach is wilted in.
- Add the pasta and mix well with the sauce. If your sauce becomes too thick at any point, add a bit of the starchy pasta water to get it back to the right consistency. It will continue to thicken the longer it sits on the burner. Serve with fresh Italian herbs and shaved Parmesan cheese (use a vegetable peeler).
- You can use 2 to 4 Italian sausage links, depending on how meaty you like it!
- Use any combination of tomato and cream to make the pink sauce such as heavy cream, half & half or milk, and any canned tomato product, marinara sauce, or 3 large fresh chopped tomatoes.