Start the pasta water first. Bring a big pot of water to a boil and salt it. Cook the pasta until it is just tender, then drain it. Remember to save a little pasta water.

While the pasta cooks, brown the sausage in a large skillet. If it is in casings, remove them and break it up with a spoon. Let it get some color.

Add onion to the skillet and cook for a few minutes until it softens. Stir in garlic for about 30 seconds so it smells fragrant but does not burn.

Stir in tomato paste and let it cook for a minute to enhance its sweetness.

Pour in the crushed tomatoes and sprinkle in Italian seasoning. Let it simmer for about 5 to 8 minutes.

Turn the heat down low, then add the cream. Stir until it turns a gorgeous blush color. Add grated parmesan and stir again.

Toss in the drained pasta. If the sauce feels too thick, splash in a little pasta water until it coats everything nicely.

Taste and adjust seasoning. Add salt, black pepper, and possibly red pepper flakes as desired.