Cacio e Pepe Pasta with Italian Sausage, Garlic Cream Sauce & Toasted Walnuts
Mar 02, 2026
Is it just me, or are my mom and I getting really good at giving classic recipes a totally unique twist? This Cacio e Pepe Pasta with Italian Sausage, Garlic Cream Sauce & Toasted Walnuts is definitely no exception. We took a classic cacio e pepe and gave it a boost with our family’s tried and true garlic cream sauce and some extra special ingredients to make it truly unforgettable. And the best part? It couldn’t be easier to make.
Cacio e Pepe Pasta with Italian Sausage, Garlic Cream Sauce & Toasted Walnuts
Equipment
- 1 large/deep frying pan
- 1 small frying pan
- 1 large pot
- 1 mortar and pestle or grinder
Ingredients
- 450 grams pasta, cassarecce
- 1/4 cup butter
- 2 garlic cloves, minced
- 2 tsp black peppercorns, coarsely cracked
- 250 grams ground Italian sausage
- 2½ cups heavy cream, 35%
- 2 cups parmesan cheese, finely grated
- 1/8 tsp nutmeg, ground
- 1 tsp lemon zest
- 1/4 cup toasted walnuts, to garnish
Instructions
- Bring a large pot of salted water to a boil and cook the pasta one minute less than the package instructions. After you drain the pasta, add a small splash of olive oil and toss it gently to keep the pasta from sticking.
- In a mortar and pestle (or grinder), add 2 teaspoons of black peppercorns and grind them until finely cracked. Set aside until ready to use.
- In a medium saucepan, add the ground Italian sausage and cook over medium-high heat until browned. If the sausage is very oily, use a paper towel to remove any excess oil so the sauce stays balanced. Then turn off the heat and set aside until ready to use.
- In a separate large deep saucepan, set to low-medium heat, add the butter. Once melted, add the ground pepper and the minced garlic. Cook on low, stirring often, until fragrant, letting the pepper infuse into the butter.
- Pour in the heavy cream and nutmeg. Using a whisk, whisk until the nutmeg is combined, then bring to a low simmer for 3 to 4 minutes, allowing it to reduce slightly.
- While the cream simmers, freshly grate your parmesan cheese – this ensures a silky smooth sauce without any grittiness. Once the cream is slightly reduced, add the parmesan cheese a quarter cup at a time, whisking well after each addition, waiting until fully melted before adding more. Allow the sauce to simmer until thickened.
- Add the cooked Italian sausage to the cream sauce, along with the drained pasta. Increase the heat to medium and stir everything together, allowing the flavors to meld. Taste and adjust seasonings if needed – no added salt is usually required.
- Turn off the heat, transfer the pasta to a large serving bowl, and garnish with toasted walnuts, lemon zest a more parmesan cheese.
- Serve right away.
Nutrition
Nutrition information is automatically calculated, so should only be used as an approximation.
Can I use a different type of pasta?
Yes, you can use any pasta you like, but I recommend shorter shapes like penne, rigatoni, or macaroni.
Can I make this recipe in advance?
I don’t recommend it. You can prep the sausage ahead of time, but the dish is best served right away, as the cream sauce will thicken.
Do I need to use the toasted walnuts?
No, not at all! If you prefer or have a nut allergy, simply leave them out – they just add a nice crunch.
How do I store the leftovers?
If you have leftovers, they’ll keep in the fridge for up to 3 days. Just note that the cream sauce will change in texture and flavor, so reheat it gently – either in a pan with a splash of cream or in the microwave. But it’s best enjoyed fresh!
This is definitely going into our regular rotation! SOOOO yummy you have to make it.