Italian Sausage Fettuccine Pasta

Creamy Italian sausage fettuccine pasta is a hearty pasta recipe made with hot Italian sausage in a tomato base sauce, fettuccine pasta smothered in a creamy white sauce, and topped with mozzarella cheese. Three layers of pure comfort: a creamy white sauce and pasta, the Italian sausage with sauce on top, followed by shredded mozzarella cheese, then baked until the cheese is hot and bubbly. Absolutely scrumptious!

Fettuccine alfredo on a plate with a mix of meat sauce and alfredo sauce.

This delicious dish is one that I’ve only just started making, but so far, it’s been a major hit with the family. I love the unique flavor of the hot sausage with the sauce that’s basically equal parts tomato and alfredo sauce. I’ve discovered that this dish is the kind that I can make for family dinners on the weekend when the kids come over or bring to potlucks and other parties. It’s so easy and so good, and I can make it in larger batches if I need to, which makes it an incredibly versatile dish. That’s exactly the kind of recipe I need for my life, so this one has quickly become a favorite of mine. I also love a nice kick of spicy heat, and this dish delivers that, as well. It’s a winner all the way around!

Italian Sausage Fettuccine Pasta

This is a bit of a Frankenstein’s monster, and I mean that in the best way possible. While there are creamy tomato sauces out there that simply add some cream to the sauce, this dish actually combines two different sauces. Hot Italian sausage and Slap Ya Mama seasoning add a one-two punch of zesty heat to this dish. Then, I combine it with a simple tomato sauce and alfredo sauce to create the ultimate creamy tomato sauce. It’s seriously one of the best sauces you’ll ever make OR taste. Then, it’s all combined with al dente fettuccine to create a rich, creamy, tomato and cheese feast loaded with meaty sausage and a kick of heat that’s substantial but won’t have you running for the water.

A landscape photo of a large plate with pasta on it, covered in meat and alfredo sauce.

Why You’ll Love This Italian Sausage Fettuccine Pasta

  • It’s a super hearty dinner with outstanding flavor.
  • It’s a creamy, cheesy pasta recipe that combines zesty, hot Italian sausage meat sauce with creamy white sauce to create the most unique sauce you’ve ever had. Then it’s all topped with mozzarella cheese and baked to perfection!
  • It’s a favorite family pasta recipe that’s always a welcome addition to any dinner recipe rotation.

Italian Sausage Fettuccine Pasta Tips and Variations

This recipe is a simple affair, so I only have a few basic tips here to help you make it absolutely amazing. I have some fun variations here that I think you’ll enjoy, too!


  • Cook your pasta to al dente and no further. Most people cook their pasta for too long and create limp, wobbly pasta that doesn’t complement the sauce well. No judgment here. I used to do it, too!
  • Whisk or stir your roux continuously and your sauce frequently when making the cream sauce to prevent burning or sticking.
  • Don’t cook your sausage and onions on heat that’s too high. You want to soften the onions, not brown or crisp them.


  • Try adding shrimp to this dish for a delicious flavor combination.
  • Use your favorite short noodle for a dish you can eat with a spoon.
  • For even more flavor, top your pasta with an Italian cheese blend before baking.
A baking dish full of Italian sausage fettuccine alfredo.

What to Serve with Italian Sausage Fettuccine

You can serve almost any of your favorite sides with this delicious pasta dish. Some of my favorites are:

  • Simple side salad
  • Crusty bread
  • Garlic bread
  • Cheesy garlic bread
  • Your favorite vegetables
  • Tiramisu for dessert

Italian Sausage Fettuccine Pasta FAQ

The following FAQ answers the most commonly asked questions about fettuccine and pasta.

What goes with fettuccine alfredo?

You can put a lot on or next to fettuccine alfredo. Some great options include:

  • Shrimp
  • Crab
  • Lobster
  • Grilled chicken strips
  • Meatballs
  • Broccoli
  • Green beans
  • Mushrooms
  • Salad
  • Crusty bread
  • Garlic bread
  • Garlic cheese bread
  • Asparagus

Why is it called fettuccine?

Fettuccine translates to “little ribbons”, which is exactly what the pasta looks like.

How long will Italian sausage fettuccine pasta last in the fridge?

It will keep in an air-tight container for 3 to 4 days.

Can you freeze fettuccine with Italian sausage?

Absolutely. It freezes very well and will keep in the freezer for up to 3 months.

A close up photo of pasta, showing the alfredo and meat sauce.

How to Store and Reheat Leftover Italian Sausage Fettuccine

Store leftovers in an airtight container in the refrigerator for up to 4 days. For longer storage, you can freeze it for up to 3 months. Simply place the pasta in an air-tight, freezer-safe container or heavy-duty freezer bag.

To reheat this pasta, place it in a baking dish and cover it. Then, bake it at 325 degrees for 20 minutes until hot.

Italian Sausage Fettuccine Pasta Ingredients

You’ll need a few ingredients to make this recipe, but they’re all very simple. You’ll find them easily at your local grocery store.

For the Meat Sauce

  • Ground hot Italian sausage
  • Onion, diced
  • Garlic powder
  • Slap ya mama
  • Black pepper
  • Red pepper flakes
  • Tomato sauce
  • Tomato paste
  • Oregano
  • Basil

For the White Sauce

  • Butter
  • All purpose flour
  • Heavy cream
  • Shredded Parmesan cheese
  • Salt and pepper, to taste
  • Pasta water
  • Mozzarella cheese, shredded
  • Fettuccine pasta
Fettuccine noodles twirled on a fork, sitting over a helping of pasta.

How to Make Italian Sausage Fettuccine Pasta

Making this recipe is a simple affair. Bothe the meat sauce and white sauce are straightforward, and after you make them, it’s a simple matter of putting the dish together.

Step 1: Prep

Preheat the oven to 350 degrees and spray a large 9×13 baking dish with nonstick cooking spray. Set aside.

Step 2: Cook the Pasta

In a large pot bring water to a boil and cook the fettuccine according to the package directions for al dente. Reserve 1/2 cup of pasta water, drain the pasta, and set it aside.

Step 3: Make the Meat Sauce

In a large skillet or frying pan, cook the Italian sausage and onions over medium-high heat until the sausage is no longer pink and the onions are tender. Drain and return to the pan. Then, add the seasonings and stir. Pour the tomato sauce and tomato paste into the meat mixture, stir to combine, and cover and simmer, stirring occasionally while you make the white sauce.

Step 4: Make the White Sauce

Melt the butter over medium heat in a medium saucepan. Then, stir in the flour until combined. Pour the heavy whipping cream into the pan and continue stirring until incorporated. Add the parmesan cheese and stir until melted. Season with salt and pepper. Add the reserved pasta water to the cheese and stir. Finally, add the fettuccine to the sauce and stir.

Step 5: Bake

Pour the pasta and cheese sauce into the baking dish, then pour in the meat sauce. Cover with mozzarella cheese and baked uncovered for 20 minutes or until the cheese is melted. Serve with side salad and garlic bread.

A two photo collage of fettuccine pasta on a white plate.

Try This Delicious Italian Sausage Fettuccine Pasta Today

This easy Italian sausage fettuccine pasta recipe is so good and so simple. It’s the perfect combination. On its own, it makes enough to feed your family for a couple of days. Double the batch, and you’ve got a great addition to any party or potluck. Give this rich, cheesy, tomato-filled pasta dish a try, and I know you’ll find yourself making it again and again!

A three photo collage of fettuccine on a white plate with blue trim.

More Delicious Pasta Recipes You’ll Love

Buffalo Chicken Salad – An incredible pasta recipe that loaded with diced chicken and is tossed in a spicy and creamy buffalo sauce.

Chicken Sausage Alfredo Pasta – A super easy and quick dinner recipe that is made right in the Instant Pot. It’s loaded with smoked sausage, chicken breast, and is tossed in a homemade, creamy alfredo sauce.

Creamy Rigatoni – A delicious pasta recipe made with a homemade tomato sauce and a creamy homemade alfredo sauce. This dish is topped with mozzarella cheese and then baked until bubbly and delicious.

And, try this Chicken Ranch Bowtie Pasta from Deliciously Seasoned. A hearty and delicious pasta recipe made with perfectly seasoned chicken breast, spinach, and a creamy homemade sauce that is made with three different types of cheese.

Fettuccine alfredo on a plate with a mix of meat sauce and alfredo sauce.

Italian Sausage Fettuccine Pasta

Great Grub, Delicious Treats

Italian Sausage Fettuccine Pasta is a flavorful, creamy, and absolutely delicious pasta dish that is perfect for weeknight dinners.

Prep Time 30 mins

Cook Time 20 mins

Total Time 50 mins

Course Dinner, Main Meal

Cuisine American, Italian

Servings 8 Servings

Calories 1164 kcal


For the Italian Sausage Tomato Sauce

  • 2 pound ground hot Italian sausage
  • 1 onion, diced
  • 1 teaspoon garlic powder
  • 1 teaspoon slap ya mama
  • 1 teaspoon black pepper
  • ½ teaspoon red pepper flakes
  • (2) 15 ounce cans tomato sauce
  • 12 ounce can tomato paste
  • 1 teaspoon oregano
  • 1 teaspoon basil

For the Creamy White Sauce

  • ½ cup butter
  • 1 tablespoon flour
  • 2 cups heavy cream
  • 6 ounce shredded Parmesan cheese
  • Salt and pepper, to taste
  • ½ cup pasta water
  • 16 ounce box fettuccine pasta
  • 2 ½ cups mozzarella cheese, shredded


  • Preheat the oven to 350° and spray a large 9 x 13 baker with non-stick cooking spray. Set aside.

  • Cook pasta per package directions for al dente.

  • In a large skillet, or frying pan, over medium high heat, cook Italian sausage and onions until sausage is no longer pink and onions are tender. Drain and return to pan.

  • Add seasonings, stir and pour tomato sauce and tomato paste into the meat mixture. Stir to combine, cover and let simmer, stirring occasionally while making the white sauce.

  • In a medium saucepan, over medium heat, melt butter and then stir in flour. Stir to combine.

  • Pour heavy whipping cream into the pan and continue stirring until incorporated.

  • Add Parmesan cheese, stir until melted and add salt and pepper.

  • Add pasta water to cheese sauce, stir.

  • Add cooked fettuccine to cheese sauce and stir.

  • Pour pasta and cheese sauce into the prepared baking dish followed by the sausage mixture on top.

  • Cover with mozzarella cheese and bake uncovered for 20 minutes or until the cheese is melted.

  • Serve with a side salad and garlic bread.


Nutritional values are approximate.


Please note that these values can change with different brands and any modifications made to the recipe. For the most accurate information, use a nutritional calculator with the exact brands and measurements.



Calories: 1164kcalCarbohydrates: 58gProtein: 44gFat: 85gSaturated Fat: 43gCholesterol: 274mgSodium: 2134mgPotassium: 1182mgFiber: 5gSugar: 11gCalcium: 545mg

Keyword Fettuccine Alfredo, Fettuccine Alfredo Pasta

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A close up picture of a serving of pasta on a white plate.
A bite of pasta twirled on a fork.

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