If you’re looking for a quick simple meal, then this creamy sausage pasta with spinach is for you. Shallots, tons of garlic, Italian sausage, and spinach are all tossed and coated in a flavorful creamy cheese sauce. Doesn’t that sound de-lush-ous?! And it’s all done in about 30 minutes.

This is a meal that the whole family will love. It’s creamy, cheesy, garlicky, with a tiny kick from some crushed red pepper. The sauce is further enhanced with a shot of white wine because that little bit of acid brightens the whole dish.
I use Pecorino Romano cheese to make this dish because I happen to buy pounds of it - like a quarter of a wheel. Yes, it’s a lot but being Italian, I use it in many dishes like pesto, my sausage pasta bake, and my baked rigatoni with three cheeses. I use it interchangeably with Parmesan. One thing to note about using Romano cheese, it's a bit saltier than Parmesan so taste and salt to your liking.
USE SWEET OR HOT SAUSAGE...
I use sweet Italian sausages but if you live on the wild side, you can use hot Italian sausages. If you do, I would omit using the crushed red pepper unless you’re into pain.
The shallot adds great flavor as does using four cloves of garlic. So you know, I use big cloves of garlic. Again, being half Italian and half Peruvian, we like our food to have flavor.
You may think a whole container (5 or 6 ounces) of spinach seems like a lot, but it does wilt away to nothing. The important thing is that it's a green and it will give you a false sense that this dish is maybe a little healthy. It isn’t. Let’s not kid ourselves.
YOU NEED REAL CREAM TO MAKE CREAMY SAUSAGE PASTA...
I use heavy cream in this creamy sausage pasta and I would not substitute it for anything less. To make things even better, I use a good amount of Romano cheese which thickens the sauce and gives this dish its saltiness. Taste the sauce before adding more salt.
The heavy cream gives all that delicious fat to make this creamy sausage pasta but to make it more delicious we need a little acid to cut through that fat and make it shine. For that I use some white wine. You could use lemon juice if you don’t have wine. Just don’t use cooking wine - like ever. It doesn’t have to be expensive wine, it just has to be real white wine. Ok?
A LITTLE NUTMEG MAKES IT EVEN BETTER...

Finally, throw in a dash of nutmeg because this is a cream sauce and it just gives it that special something something. Nutmeg is the ingredient that makes a cream sauce better.
I’d call this a one pot meal but you need a pot to boil the pasta. The pasta needs to be cooked al dente - with a bite. We don’t want soft limpy pasta. In fact, soft and limpy is never desired, is it? Check out my post on How To Cook Pasta.

For more pasta goodness, check out:
- Sausage with broccoli and pasta
- Baked rigatoni with three cheeses
- Creamy fettuccine with peas and ham
- Angel hair with sauteed tomatoes
- Spaghetti with garlic butter and cheese
- Peruvian Pesto
- Spinach Pesto
Life is too short for mediocre food.
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Creamy Sausage Pasta with Spinach
PRINT PIN SAVEEquipment Used
Ingredients
- 1 pound penne pasta or pasta of choice
- 2 tablespoons olive oil
- 1 medium shallot finely diced
- 4 garlic cloves minced
- 1 pound Italian sausage casings removed
- 5 or 6 ounces fresh baby spinach
- 2 cups heavy cream
- 2 tablespoons white wine
- 1 cup grated Pecorino Romano cheese can substitute Parmesan
- Kosher salt to taste - remember the cheese is salty
- ¼ teaspoon crushed red pepper ½ teaspoon if you like spicy
- ½ teaspoon pepper
- ⅛ teaspoon nutmeg
Instructions
- Cook pasta until al dente - 2 minutes less than the recommended packet directions. Don’t forget to add salt to the water. Check out how to cook pasta for tips. Drain and set aside..
- Place a large 12” skillet over medium heat and add olive oil. Add the finely diced shallots and saute for about 3 minutes until softened and just starting to turn color.
- Add garlic, salt, crushed red pepper, and pepper and sauté until fragrant - about 1 minute.
- Add the sausages and break it up as you stir. I use a flat wooden spatula or good sturdy spoon to break it up. Cook until browned.
- Add in the white wine to deglaze. Scrape up any brown bits. That's flavor.
- Add in the baby spinach in batches. Add a handful at a time and stir to make it wilt then continue with remaining until it’s all added. You’ll see it wilts to nothing.
- Lower the heat and stir in the cream and nutmeg.
- Add the Romano cheese. Continue to cook, stirring, until it starts to simmer. Do not let it boil.
- Add the cooked pasta and combine until it’s all coated. Remove from heat. The sauce will appear very loose. Do not worry. It needs to sit for at least 10 minutes for it to thicken up. Stir as it sits and you will notice the sauce will go from loose to creamy, coating the pasta and sausage beautifully.
Notes
Nutritional Information
I don't post the nutritional value because I don't trust the accuracy of the nutritional apps. I’m not a nutritionist and don't want to post misinformation.
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Beth
I assume you add wine after browning sausage to deglaze?
Natalie
Yes! 🙂