This Creamy Sausage Alfredo is all about comfort! With tasty sausage and a rich, cheesy sauce, it’s perfect for a cozy dinner. Plus, it cooks up in no time!
I love how creamy and filling this dish is. It pairs wonderfully with a side salad, but let’s be real—sometimes I just grab a fork and eat it straight from the pot! 😉
Key Ingredients & Substitutions
Pasta: Fettuccine or egg noodles work best for a creamy sauce to cling to. If you don’t have them, try penne or even gluten-free pasta; they’ll still be delicious!
Italian Sausage: Use mild or spicy based on your taste! If you’re vegetarian, crumbled veggie sausage can be a good alternative. Just be aware that the flavor will change a bit.
Heavy Cream: This makes the sauce luxuriously creamy. If you need a lighter version, you can use half-and-half instead. Though, I highly recommend sticking with the heavy cream for that ultimate richness!
Parmesan Cheese: Freshly grated is key for a smooth texture. You can substitute it with Pecorino Romano if you want a sharper taste. Pre-grated cheese works in a pinch, but it might not melt as well.
How Do I Ensure My Sauce is Smooth and Creamy?
The key to a velvety Alfredo sauce is to combine the cream and cheese properly. Here’s how to get it just right:
- After sautéing garlic, lower the heat before adding cream and milk to avoid scorching.
- Whisk in the Parmesan slowly, allowing it to melt gradually. Keep stirring until smooth!
- If the sauce gets too thick, add a splash more milk until you reach your desired consistency. It should coat the back of a spoon without being too runny.
Following these steps will ensure a delightful and creamy Alfredo sauce every time! Enjoy your cooking experience!

How to Make Creamy Sausage Alfredo
Ingredients You’ll Need:
For the Pasta:
- 12 oz fettuccine or egg noodles
For the Sausage:
- 1 lb Italian sausage (mild or spicy), casings removed and shaped into small meatballs or crumbled
- 2 tbsp olive oil or butter
For the Sauce:
- 3 cloves garlic, minced
- 2 cups heavy cream
- 1 cup whole milk
- 1 cup freshly grated Parmesan cheese, plus extra for garnish
- 1 tsp Italian seasoning or dried oregano
- Salt and freshly ground black pepper, to taste
For Garnish:
- Fresh sage leaves (optional)
- Fresh parsley, finely chopped (optional)
How Much Time Will You Need?
This creamy delight takes about 30 minutes to make—10 minutes for prep and 20 minutes for cooking. It’s a quick and satisfying meal that’s perfect for any night!
Step-by-Step Instructions:
1. Cook the Pasta:
Start by bringing a large pot of salted water to a boil. Add the fettuccine or egg noodles and cook them according to the package instructions until al dente (cooked but still firm). Once done, drain the pasta and set it aside.
2. Brown the Sausage:
In a large skillet, heat the olive oil or butter over medium heat. Once hot, add the Italian sausage pieces. Cook, turning them occasionally, until browned and cooked through, about 6-8 minutes. Once cooked, remove the sausage from the skillet and set aside.
3. Sauté the Garlic:
In the same skillet, add the minced garlic. Sauté for about 1 minute until it becomes fragrant, but be careful not to let it brown.
4. Make the Cream Sauce:
Pour the heavy cream and whole milk into the skillet with garlic, stirring to combine. Bring this mixture to a gentle simmer—don’t let it boil!
5. Add the Cheese:
Slowly whisk in the grated Parmesan cheese. Keep whisking until the sauce becomes smooth and slightly thickened, which should take about 3-5 minutes. Then, stir in the Italian seasoning, and add salt and pepper to taste.
6. Combine the Sausage and Pasta:
Return the cooked sausage to the creamy sauce and stir well to coat. Next, add the cooked pasta to the skillet and gently toss everything together until the pasta is evenly coated with sauce and sausage.
7. Garnish and Serve:
If you like, sauté some fresh sage leaves in a little butter until they become crispy. Sprinkle these on top when serving for added flavor. Serve your creamy Sausage Alfredo hot, garnished with extra Parmesan cheese and chopped parsley if desired. Enjoy!

Can I Use Whole Wheat Pasta Instead of Regular Pasta?
Yes, you can! Whole wheat pasta is a great alternative that adds a nutty flavor and extra fiber. Just be sure to adjust the cooking time according to the package instructions, as it may take a little longer to become tender.
What If I Don’t Have Heavy Cream?
If you don’t have heavy cream, you can use half-and-half for a lighter version or a mixture of milk and a little flour to thicken the sauce. Another option is to use coconut cream for a dairy-free alternative; just be aware it will change the flavor profile a bit.
How Can I Make This Recipe Spicier?
If you love heat, consider using hot Italian sausage instead of mild. You could also add a pinch of red pepper flakes to the sauce for an extra kick. Just adjust according to your spice preference!
How to Store Leftovers?
Store any leftovers in an airtight container in the fridge for up to 3 days. To reheat, warm it gently on the stove over low heat, adding a splash of milk or cream to bring back the creamy texture.


