Creamy One-Pot Pasta with Sausage and Squash

It’s no secret we love food. I mean, that’s kind of the whole point of 12 Tomatoes, is it not? However, cleaning up the mess in the kitchen after an afternoon of dinner prep isn’t my idea of a good time. Sure, sometimes it’s fun and totally worth the mess if you make an amazing meal, but what if you could have a mouth-watering dinner without the mess? That’s what I call a win-win.

This creamy pasta, sausage, and squash dish is up for the challenge. It has all the makings of a complete meal, without all the hassle and mess.

This pasta dish has everything you could ever hope for in a hearty, one-pot meal. Sausage, pasta, and creamy sauce. Add in squash, sage, and nutmeg for some depth of flavor and texture, and there you have it. An earthy, cheesy, warm pot of deliciousness that the whole family will love.

Let’s talk about the creamy sauce that holds everything together. Heavy cream is added to a roux made with sausage grease and flour. It might sound odd, but trust me on this one, this is the start of a beautiful creamy sauce. Sprinkle in parmesan cheese until melted, and then stir in your spices, pasta, and squash.

Truly, this creamy, decadent meal is comfort food at its finest. I love the rich, earthy flavors that are added with the squash, sage, and nutmeg, while the rest of the family is simply happy to have a new spin on pasta. It’s like they are tired of spaghetti and red sauce once a week. Weird. Go ahead and switch up your pasta night with this amazing meal. You won’t regret it!

Creamy One-Pot Pasta with Sausage and Squash

45 Minutes to prepare serves 4


  • 3 Tbsp. extra-virgin olive oil
  • 12 oz. Italian sausage (about 3 links), casings removed
  • 1 Tbsp. all-purpose flour
  • 2 cups milk
  • 2 cups water
  • 1 cup heavy cream
  • 1 1/2 cups finely grated Parmesan, divided
  • 1/2 large butternut or Delicata squash (about 1 lb.), peeled, seeded, chopped into 1/2" pieces
  • 1/2 lb. Rotini Pasta
  • 2 garlic clove, finely grated
  • 1 sprig sage
  • 2 1/2 tsp. kosher salt
  • 1/4 tsp. nutmeg
  • Freshly ground black pepper


  1. Heat oil in a Dutch oven over medium-high. Cook sausage, breaking up into about 1" pieces with a wooden spoon, until well browned, 5–7 minutes.
  2. Add flour and cook, stirring constantly, until evenly distributed, about 1 minute.
  3. Combine milk, cream, and 2 cups water in a large bowl or glass measuring cup. Stirring sausage mixture constantly, slowly stream in milk mixture; bring to a simmer.
  4. Add 1 1/4 cups Parmesan and cook, stirring constantly, until cheese is melted.
  5. Add squash, pasta, garlic, sage, salt, and nutmeg and toss to combine.
  6. Make sure pasta is covered with liquid. Bring to a boil, then bring to a bare simmer.
  7. Cook, stirring occasionally, until pasta is cooked through, squash is beginning to break down, and sauce is reduced and glossy, about 20 minutes.
  8. Pluck out and discard sage. Transfer pasta to a platter. Top with remaining 1/4 cup Parmesan and a few cranks of pepper.

Recipe adapted from Epicurious.