
I first discovered this combination at a small trattoria in Florence. The owner shared that the secret lies in the quality of the pesto and the perfect cooking of the pasta. After returning home, I spent weeks perfecting this recipe. The key is using freshly made pesto rather than store-bought - it makes a world of difference. The Italian sausage adds a rich, savory element that transforms this from a simple pasta dish into something truly special. When the hot pasta meets the pesto, it creates this incredibly aromatic experience that fills the whole kitchen.
Why I love this recipe
This recipe holds a special place in my heart because it combines simplicity with incredible flavor. I love how the pesto coats each strand of fettuccine perfectly, creating a silky sauce that's both light and satisfying. The Italian sausage adds just the right amount of richness and protein, while the Parmesan brings that sharp, salty finish that ties everything together. It's also incredibly versatile - I can make it for a quick weeknight dinner or dress it up for guests. The leftovers (if there are any!) taste even better the next day as the flavors continue to develop.
What You Need From Your Kitchen
- Fettuccine: Cook until perfectly al dente
- Italian Sausage: Remove from casings and crumble while cooking
- Basil Pesto: Use fresh, homemade if possible
- Parmesan: Freshly grate just before using
- Garlic: Mince finely for even distribution
Let's Make These Together
- Prepare Your Ingredients
- Gather all ingredients and prep them before starting to cook.
- Cook the Pasta
- Boil pasta in well-salted water until al dente, reserving some pasta water.
- Brown the Sausage
- Cook sausage until well-browned and crumbly.
- Create the Sauce
- Combine pesto with cooked sausage and pasta, adding pasta water as needed.
- Final Touch
- Finish with fresh Parmesan and adjust seasoning to taste.

Switch Things Up
One evening, while experimenting with my usual pesto pasta recipe, I decided to add some crumbled Italian sausage. The way the savory meat complemented the herbal pesto was a game-changer. Now, I always keep some Italian sausage in the freezer just for this dish. The key is getting the pasta perfectly al dente and using high-quality pesto.
Perfect Pairings
Serve this pesto fettuccine with a crisp arugula salad dressed with lemon vinaigrette. For wine lovers, a glass of Pinot Grigio or Vermentino complements the herbal notes of the pesto beautifully. Garlic bread or focaccia makes an excellent side to soak up any extra sauce.

Frequently Asked Questions
- → Can I use different pasta shapes?
Yes, any long pasta like spaghetti or linguine works well, but fettuccine is ideal for holding the pesto sauce.
- → Can I make this vegetarian?
Absolutely! Replace sausage with sautéed mushrooms or plant-based sausage alternatives.
- → How long does this keep?
Stores well in an airtight container in the refrigerator for up to 3 days.
- → Can I freeze this dish?
While possible, it's best enjoyed fresh as freezing can affect the texture of the pasta and pesto.
- → Is there a low-carb version?
You can use zucchini noodles or other vegetable pasta alternatives.
Conclusion
This Pesto Sausage Fettuccine is a perfect blend of Italian flavors that comes together in just 35 minutes. The combination of fresh pesto, savory sausage, and al dente pasta creates a restaurant-worthy dish that's surprisingly easy to make at home. It's an excellent choice for both weeknight dinners and special occasions.