Bowtie Pasta with Sausage, Tomatoes and Cream is one of our favorite meals. It’s simple enough to make on a weeknight and special enough to serve to dinner guests!
Bowtie Pasta with Sausage, Tomatoes and Cream
My friend Laurie, also famous for a few other recipes on this blog (Laurie and Amy’s Amazing Chocolate Cake, Laurie’s Amazing Carrot Cake, Laurie’s Creamy White Chili, Laurie’s Lemon Bars) gave me this recipe. If you’re new to ABK, here’s a tip- anything with this woman’s name on it is amazing and worth making.  This dish is perfect for almost any occasion. I mean, really now. Who doesn’t love pasta, cream, tomatoes and cheese??  Throw in a little sweet Italian sausage… Perfection in a bowl.
Bowtie Pasta with Sausage, Tomatoes and Cream
Oh, and I forgot to mention. It takes less than 30 minutes start to serve.
You’re going to love this.
And your family will too.

Bowtie Pasta with Sausage, Tomatoes and Cream

5 from 1 vote
Author: Si Foster


  • 1- 1 lb package bow tie pasta, I use about 3/4 of the package
  • 1 lb sweet Italian sausage
  • 1/2 teaspoon red pepper flakes
  • 1 cup chopped onion
  • 1-2 cloves garlic, minced
  • 1 lb fresh mushrooms, washed and sliced
  • 3- 14.5 oz cans Italian style diced tomatoes, drained
  • 1 1/2 cups heavy cream
  • 1/2 cup fresh grated Parmesan cheese
  • salt to taste
  • 1/4 cup fresh basil, chopped
  • additional Parmesan or Romano cheese, fresh grated


  • Cook pasta in boiling water according to package directions. Drain, toss with a little olive oil and set aside.
  • Using medium-medium high heat cook sausage until done, breaking up sausage into bite size chunks while cooking. When sausage is cooked, remove from pan and pour sausage onto paper towels to remove grease.
  • Do not wipe out pan, most of the grease should have been removed with meat.
  • Add chopped onion, sliced mushrooms and pepper flakes to pan. Cook until onions and mushrooms are tender about 5 minutes. Add garlic during last minute of cooking.
  • Stir in drained tomatoes, cream and salt. Add the cooked sausage back to the mixture as well. Simmer until mixture is thickened a bit, about 8-10 minutes.
  • Add about 1/2 cup grated Parmesan cheese to sauce.
  • Stir cooked pasta into sauce, or pour sauce over cooked pasta on platter. Sprinkle with chopped fresh basil and grated Parmesan or Romano cheese.


-I use a mixture of part sweet Italian sausage and part spicy sausage.-You may use part half and half, and part cream.-I have used both Italian chopped tomatoes, or cans of plain chopped tomatoes. -To lighten this up, you could use 2-3 chicken breast halves and all half and half. Or, substitute ground turkey, generously season with salt and pepper.-When tomatoes are in season, use fresh juicy tomatoes, such as beefsteak tomatoes. Chop several into a bowl, scooping juice into the bowl as well. Measure out about 5 1/2 cups of fresh tomatoes and juice. Add 2 teaspoons of salt, pinch of sugar and any of the following fresh or dried herbs, about 3 tablespoons fresh each or 1 tablespoon dried: parsley, thyme, oregano.-This can also be made in the slow cooker. Cook the sausage, drain and place in slow cooker. Add the rest of ingredients, except the cream. Cook on low for 6-8 hours. The last half hour of cooking, add the cream. Stir and turn temperature to high. Serve as directed over cooked pasta, top with fresh basil.

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Bowtie Pasta with Sausage, Tomatoes and Cream