This pasta dish is a hearty minefield of flavors that will make you so happy on a chilly night! It's so good that we'd eat it in the dead of summer, too, but this is packed with fall and winter flavors. How can you go wrong with pasta, creamy sausage sauce, and some amazing mushrooms to bring even more depth to the sauce? This Tagliatelle with Sausage Mushroom Cream Sauce will warm your heart and soul!

We are all about the homemade pasta life! And we have also included below how to make hand-cut tagliatelle without a pasta cutting machine!
What's in the sauce?
Obviously, mushrooms and sausage are the heart and soul of this dish, but there are a few other little things that bring the flavor home as well.
For the sausage, we prefer to use a sweet or spicy Italian sausage for this application. Often you will find these sausages sold in links, so it is important to remove the sausages from their casings before cooking.
Our mushroom of choice for this recipe are cremini mushrooms, sliced. These mushrooms are readily available in stores and provide the flavor and texture we want in this sauce.
We chose the base herb to be rosemary, but this could be done with sage as well with equally amazing results. Any winter herb will do here, but we really love rosemary in this sauce.
Finally, truffle oil and parmesan are added at the end to finish the sauce, and they are just over-the-top delightful in this.
We like to garnish this dish with fresh oregano, shaved parmesan, and a pinch of red pepper flakes to give it a little heat. We went ahead and stepped it up another level this time and added freshly shaved winter black truffles over the top, as well. This is definitely an optional part of the recipe since truffles are very challenging to get your hands on and can cost a pretty penny. But if you happen to have some, this is the perfect dish to shave them right on top to serve.

Hand Cutting Pasta Dough for Tagliatelle with Sausage Mushroom Cream Sauce
We are big advocates of making pasta from scratch. There really is no comparison when it comes to homemade versus the store bought versions. But we also understand that many people don't have the equipment, such as a pasta roller or cutter at home. Although these make your life easier for pasta making, you can also make pasta without any special equipment, besides a rolling pin and a knife. So, don't fret, and just give it a try!
For this particular recipe for Tagliatelle with Sausage Mushroom Cream Sauce, we usually roll out the pasta sheets using our pasta roller or with a rolling pin. Then we fold the sheets and cut into tagliatelle ribbons. Tagliatelle is similar in shape and cut to fettuccine but the noodles are often thinner and slightly wider. Tagliatelle should be about 6-8 mm wide (about ¼ inch) when cut properly.
The thin, ribbon-like texture of tagliatelle is perfect for heavier sauces like the traditional Bolognese or other meat ragù sauces, like our Pork and Shiitake Mushroom Ragù.
The most important thing you need for hand-cut pasta is a sharp knife to make clean cuts through the folded pasta sheets.
Enjoy!
We hope you enjoy this recipe for Tagliatelle with Sausage Mushroom Cream Sauce. If you give it a try, leave us a comment below, or tag us on Instagram @cooking_with_wine!
Looking for more pasta recipes? Check out these:
- Pork and Shiitake Mushroom Ragù
- Roasted Zucchini and Tomato Pasta
- Pumpkin Ravioli with Parmesan Sage Cream Sauce
- Chicken Piccata with Caper Lemon Butter Sauce
📖 Recipe

Creamy Sausage Mushroom Pasta (Italian Restaurant-Style)
Ingredients
Pasta
- 12 oz pasta tagliatelle or fettuccine
For the Sausage Mushroom Cream Sauce
- 1 tablespoon vegetable oil
- 1 Lb. mild Italian sausage removed from its casing
- ¼ cup onion finely chopped
- 1 tablespoon fresh rosemary finely chopped
- 2 teaspoon fennel seeds whole
- ½ teaspoon ground cloves
- 1 cup heavy cream
- 1 tablespoon unsalted butter
- 12 oz cremini mushrooms sliced
- 4 cloves garlic minced
- ½ teaspoon black pepper
- 1 teaspoon kosher salt
- ¼ cup sweet vermouth
- ¼ cup dry white wine
- 2 tablespoon lemon juice
- 2 tablespoon fresh parsley chopped
- ⅛ teaspoon white truffle oil
- 1 cup parmesan cheese freshly grated
Garnish (optional)
- Fresh oregano chopped
- Red pepper flakes
- Grated parmesan cheese
- Toasted bread crumbs
- Shaved truffles (super optional)
Instructions
Make the Sauce
- To a large pan, add the oil to coat the bottom over medium heat. Add the sausage and break it up as it cooks with a wooden spoon. Cook until browned and almost cooked throughout, about 5 minutes. Just before the sausage is finished cooking, drain off the excess fat rendered from the sausage, leaving behind about a tablespoon.1 tablespoon vegetable oil, 1 Lb. mild Italian sausage
- Next, add the chopped onions to the browned sausage and cook until the onions are translucent, about 5-7 minutes.¼ cup onion
- Add the rosemary, fennel seeds, cloves, and cream to the sausage and onions and stir. Turn the heat off and set aside.1 tablespoon fresh rosemary, 2 teaspoon fennel seeds, ½ teaspoon ground cloves, 1 cup heavy cream
- In a separate large skillet, melt the butter over medium to medium-high heat until it stops foaming. Add the mushrooms and cook, stirring often, until the mushrooms are tender and have begun to brown, about 5-7 minutes. Add the garlic, pepper, and salt, stir and cook for about 30 seconds. Pour in the vermouth and wine to deglaze and cook until most of the liquid has evaporated, about 3-4 minutes.1 tablespoon unsalted butter, 12 oz cremini mushrooms, 4 cloves garlic, ½ teaspoon black pepper, 1 teaspoon kosher salt, ¼ cup sweet vermouth, ¼ cup dry white wine
- Add the mushroom mixture to the sausage and cream mixture and stir. Stir in the lemon juice and parsley. Keep this mixture simmering on low while you cook the pasta.2 tablespoon lemon juice, 2 tablespoon fresh parsley
Cook the Pasta and Finish the Dish
- Bring a large pot of salted water (2 tablespoon for 6-8 quarts of water) to a hard boil and add your dry pasta. Cook to al dente following the package directions.12 oz pasta
- When the pasta is almost done, add the truffle oil and Parmesan cheese to the sauce. The sauce will be thick and creamy and can be thinned slightly with cooking water from the pasta if needed.⅛ teaspoon white truffle oil, 1 cup parmesan cheese
- Once pasta is done, transfer to the pan with the sauce and toss to combine thoroughly. Thin out with some pasta water if necessary then serve.
- You can garnish with any of the following optional garnishes: chopped oregano leaves, red pepper flakes, parmesan cheese, toasted breadcrumbs and shaved truffle.Fresh oregano, Red pepper flakes, Grated parmesan cheese, Toasted bread crumbs, Shaved truffles






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