I made this dish for my boyfriend, who is somewhat weary of any dish that is too heavy. He loved this dish! So did I for that matter. I was told from my roommate, who had the leftovers, that the dish looked and tasted like something that she gets from the Italian restaurant she works in. I'll be making this again for sure!

As the lucky beneficiary of this sausage-cream gravitational force, I can vouch for its goodness (and for its affinity with full-bodied red wine, several glasses of which do tend to make me talk more than usual about stone fruit). I'll look forward to a pluot tart recipe this summer.

This is one of my "signature" dishes and everyone who has tried it, LOVES IT!!! I got it from allrecipes.com a few years ago. I sometimes add "italian" seasoning to the mix and it comes out great! Another WINNER Elise! Keep them coming!!!

p.s. Love you, your family and your site! :-)

I'd be worried about the garlic burning. Wouldn't you cook the sausage first, moving it the edge of the pan and then adding first the shallots, and then the garlic? Just quibbles, tho, this looks like a great recipe; I bought the ingredients yesterday.

I am not a huge fan of fetuccine, so I substituted penne and it was divine. Your recipes are always so easy and so good!

This is so easy and sinfully delicious. My daugher-in-law made it for dinner and everyone asked for the recipe. It's a keeper!! Even the little ones gobbled it up.

This turned out great! I use your site all the time for new ideas. Thanks so much and please keep it up!

Oh-my-god! This was so good, I almost cried! I used one can of Mexican style tomatoes and 1 can of Italian style tomatoes, 3 cloves of garlic. The sage, the sage, the sage...

I absolutely love this recipe! I have made it about 6 times and each time I add my own little flavor.

One tip that I will say about this recipe is DO NOT FORGET THE SAGE! You will notice that it is missing and it adds that little extra "zing".

I always double up on this recipe as well since there is never any left. When I double up, I have some leftovers for lunch the next day (yummy).

I tend to leave out the shallots as they are pretty potent and cannot chop them up. I end up crying for 3 hours, lol!

Another thing I like to do is get the "flavored" diced tomatoes. The Italian is superb with this dish and really brings out the flavor. And I only use the spicy sausage.

For some extra flavor, try adding spices to your noodles while they boil! I like sea salt with garlic.

I saw this recipe too and ran out to buy the ingredients. It was absolutely DELICIOUS!! I added a cup of spinach for some extra colour and umph!! Kids loved it! Just used mild tho!

Just cooked it again this weekend, loved it. Better this time around as it simmered for a longer time, reducing the sauce does make a difference. Having leftovers tomorrow for lunch :)

Anything with Italian sausage (hot or sweet) and heavy cream and pasta is a must try. I've made a similar recipe and have added grilled eggplant as a side dish (which ended up being mixed in with the sauce from the pasta/sausage/heavy cream recipe).. Add a bit of hot pepper flakes for a real "bite"

I made this tonight with your bruschetta and it was YUM-MY! Even my mother who hates sausage really liked it. I substituted the shallots for a large sweet onion and I used all sweet sausage instead of 1/2 sweet and 1/2 spicy. This one's definitely a keeper! Thanks a bunch!

I made this the other night, it was delicious but I had to do the shallots/garlic twice because they burned the first time. Any tips on avoiding this? Start out on a lower heat perhaps? And what kind of pan is best? I think my pot might've been a part of the problem. It was amazing though and so easy! Thanks!

I burn garlic all the time. I think the best thing to do is to pay attention while cooking and not look away. You can also lower the heat. ~Elise

This looks fantastic! I have a question though, since I'm not familiar with sausages, but is it possible to make it with only sweet sausages? I have some people who can't eat spicy and I'm not sure if they'd be able to take spicy sausages :)

Sure, if you don't like spicy sausage, use sweet. ~Elise

I've raved about this recipe to many people I work with at a big grocery store, and it has become a massive hit. One of my bosses calls it "crack in a pan", and I agree. Its a favorite around here, and I have to resist making it more, or it will lose that "special dinner" feel.

I also gave a link to this to a friend in the US (I'm in Canada) and when his girlfriend showed it to him, he "tried to drown himself in drool". They've since made it multiple times and love it.

While I wouldn't want to change a thing, the only question I have would be if you've tried it with a lighter cream and turkey italian sausage to lower the fat content, and how it may have affected the taste.

Other than that, I love this recipe. Absolutely delicious!

Oh, I am totally okay with archive updates when they look like this! In college, we had a pasta bar at lunch where they cooked the pasta one serving at a time and then topped it with sausage and your choice of a heavy white alfredo-ish sauce and a sort of bland tomato sauce. Neither of the sauces were great on their own, but I always asked for them mixed together, and the combination was great. This creamy tomatoey sausagey sauce looks like the grown up version of my favorite college pasta, I will have to give it a try!

I'm a vegetarian, so I know this shouldn't appeal to me. But that picture got me salivating. I LOVE that thick fettuccine. I know this may sound absurd, but I'm thinking of trying a veggie version with TVP mince.

Oh lord, this looks wonderful! There is a wonderful recipe that is somewhat similar to this one in the River Cafe Cookbook...I lived on it in grad school, I really cannot recommend it enough!

This looks fabulous! It's definitely on my list for later this week.

Everything in this dish is just what we like.

I made a similar version, last night, and it was delicious. Used only spicy Italian sausage. We like spicy food.

I make this using penne pasta and I add a
splash of red wine and use basil instead
of sage. I will try it with the sage next
time. Very good recipe.

I'm making this for dinner tomorrow night. I just picked up all the ingredients. We're really looking forward to it. Thanks!

Elise, you are my new secret weapon! I cooked this last night for my husband, and he loved it. Yummm! Thanks.

This has become a regular star in my lineup since I originally found it a couple of years ago. One recommendation... have on hand a nice chewy slice of french bread for dipping into the sauce and "testing" while you're cooking. I could eat it like that without the pasta!

I have always love this recipe. This is my special "when friends come over" recipe and it is without fail, always a hit.

A pound of sausage, and a cup of cream etc. among how many servings? The recipe says 6. It's not like this is for one person. That makes it 2.6 ounces of sausage per serving, and 2.6 tablespoons of cream per serving. Hardly excessive.

It seems to me that one always has to take servings into consideration and not have fits over the absolute amounts any given recipe calls for.

Having ranted, I'll add that I made this last night and it's delicious! I'm looking forward to leftovers tonight. :)

I made this yesterday and it was delish. This one goes in the recipe book.

I made this for my husband last night and he gobbled it up! I added 1 serrano chilli to the sausage and ended it with some fresh cilantro as garnish, so it ended up becoming an Indo Italian pasta :). I'm going to make this at least once a month. love it. love it!

This is a great simple recipe. Thank you! I have made it twice in the last week; the first time a double batch which I shared with a couple of friends, and the second time had friends over to share. Many people have eaten it and they all love it. I added lots of oregano and the last of the basil frozen from the summer.

Yum! A solid weekday meal that makes great leftovers, but not something that made me go WOW. Mine wasn't as colorful as yours seems, perhaps a little tomato sauce and greens would liven it up a bit.

Hi Elise, one of your readers wondered about using a lighter cream in this recipe. I made the dish again tonight and used half-n-half (10% fat) instead of whipping cream. The sauce didn't thicken up so I added 1 tsp of cornflour (mixed with 1 tsp water) and it did the trick. Can't really comment on whether it tastes the same as I used different sausages and herbs this time but it tasted good to me!

Thanks for letting us know! ~Elise

I made this tonight and it is such a keeper! Half recipe made enough for four. We both loved it! Thanks, Elise.

Extreme deliciousness.

This recipe is divine....I like using orechiette shaped pasta (little ears) as they seem to hold little pools of the wonderful sauce....cream, tomatoes, sausage...so delicious. This is one of my favorite pasta dishes, thanks Elise!

Since making this recipe several months ago, it has become one of my husband's favorites! I dice up carrots and broccoli (blanch them beforehand) and then throw them in near the end. Makes me feel a little better about getting some veggies...and they add a great crunch!

Hi Elise,
Im not a big fan of sweet Italian sausage, so I was wondering if this would still be good if I changed it up a bit, like chorizo instead of Italian sausage and rice instead of fettuccine? Or maybe you know some good variations of this recipe? I'm kind of new to cooking but I just thought I would ask.

Hi Sarah, everyone's taste is different. Usually I try to make a recipe as given first, then change it to adapt it to my taste. You should feel free to experiment as much as you want with this recipe, it's just a guideline. As for chorizo and rice, try it if you want! I love the recipe as is, so wouldn't make changes personally. ~Elise

Delicious recipe! Next time, though, I will add some more spice to it :). Thanks Elise, for a great recipe! My husband thoroughly enjoyed it.

Tonight I had the leftovers of this dish from a couple of nights ago.Oh my goodness, it was even better. We just loved it. It is a super dish to make for company the day before,and just warm it up before they arrive. Wow! FANTASTIC.