This creamy butternut squash pasta with sausage and spinach quickly became a weeknight staple in my kitchen after a chilly autumn evening experiment. I discovered the combination by accident when I had leftover roasted squash and a packet of sweet Italian sausage. The smooth, velvety squash melded with the salty tang of Parmesan and the savory meatiness of the sausage, creating a balanced sauce that clings beautifully to tubular pasta. The spinach adds a fresh green lift and just enough texture to keep every bite interesting.

What I love most about this dish is how approachable it is. With 8 ounces of pasta and a single medium squash, it feeds four without fuss. The sauce comes together in the skillet in minutes because the squash, once cooked, purees into a silky base that needs only cream and cheese to become luxurious. It is both comforting and elegant enough to serve when friends pop by unexpectedly. The memories I have around this dish include a rainy Monday night and a bowl passed around until it was entirely empty. Picky eaters surprised me by asking for seconds, and leftovers reheated the next day tasted nearly identical to freshly made.

Ingredients

• 8 ounces pasta (penne or rigatoni): Choose a sturdy tube that holds sauce well. I like a traditional semolina penne for texture, and Barilla or De Cecco cook reliably to al dente.
• 1 medium butternut squash, peeled and cubed: Look for a squash weighing about 2 to 3 pounds. Roasting enhances natural sweetness and reduces moisture for a creamier sauce.
• 1/2 pound Italian sausage, casings removed: Use sweet or mild Italian pork sausage; spicy is also excellent if you prefer heat. Remove casings so the meat browns evenly.
• 2 cups fresh spinach: Baby spinach works best because it wilts quickly and adds a tender green note without overpowering the creamy sauce.
• 1/2 cup heavy cream: Adds silkiness and helps suspend the puree as a sauce. For a lighter version, use half and half though texture will be slightly thinner.
• 1/2 cup grated Parmesan cheese: Freshly grated Parmigiano Reggiano delivers the best nutty flavor and improves sauce body; pre-grated will work in a pinch.
• Salt and pepper to taste: Kosher salt and freshly cracked black pepper highlight the squash and balance the sausage saltiness.

Instructions

Cook the pasta: Bring a large pot of salted water to a rolling boil and cook 8 ounces of penne or rigatoni according to package directions until al dente, usually 10 to 12 minutes. Reserve about 1/2 cup of the cooking water before draining; the starchy liquid helps loosen the sauce if needed. Drain and set the pasta aside in the colander while you finish the sauce. Brown the sausage: In a large skillet over medium heat, add the Italian sausage after removing casings. Break it into bite sized pieces with a wooden spoon and cook for 6 to 8 minutes until well browned and cooked through. Transfer the cooked sausage to a plate lined with paper towel to drain excess fat, leaving about 1 tablespoon of drippings in the skillet for flavor. Prepare or roast the squash: If you have raw cubed squash, roast at 400 degrees Fahrenheit on a rimmed baking sheet tossed with a drizzle of oil and a pinch of salt for 20 to 25 minutes until tender and caramelized at the edges. Alternatively, pan sauté the cubed squash until soft, but roasting concentrates sweetness and reduces excess moisture in the sauce. Blend the squash into a sauce: Add the roasted butternut squash to the same skillet and pour in 1/2 cup heavy cream. Use an immersion blender to puree until silky, or transfer to a countertop blender and pulse until smooth, then return to the skillet. Warm gently over low heat. Stir in 1/2 cup grated Parmesan, then season with salt and freshly ground black pepper to taste. The Parmesan thickens and rounds out the sauce while the cream smooths texture. Combine and finish: Add the drained pasta, cooked sausage, and 2 cups fresh spinach to the skillet. Toss over low heat until the spinach wilts and everything is heated through, 2 to 3 minutes. If the sauce feels too thick, add reserved pasta water a tablespoon at a time until the desired coating consistency is reached. Serve immediately with an extra sprinkling of Parmesan.

Storage Tips

Cool leftovers to room temperature for no more than two hours before refrigerating. Store in an airtight container for up to three days. Reheat gently on the stove over low heat with a splash of water or cream to revive sauce creaminess and to prevent drying. For longer storage, freeze in a heavy duty freezer container for up to three months. Thaw overnight in the refrigerator and reheat slowly. Use glass containers or BPA free plastic to maintain flavor and minimize condensation.

Ingredient Substitutions

If you want a lighter version, swap 1/2 cup heavy cream for 1/2 cup evaporated milk or for 1/2 cup unsweetened almond milk plus 1 tablespoon cornstarch to thicken. For a vegetarian alternative, replace sausage with 1 cup cooked lentils or crumbled tempeh browned with Italian seasoning. To make it gluten free, use certified gluten free pasta and check sausage labels for hidden gluten. For a nuttier flavor, stir in 2 tablespoons toasted pumpkin seeds just before serving.

Serving Suggestions

Serve with a crisp green salad dressed with lemon vinaigrette to cut richness. A side of oven roasted Brussels sprouts or a simple garlic sautéed broccoli pairs well. Garnish with more grated Parmesan and a few grinds of fresh black pepper. For a dinner party, present in a warmed shallow bowl and top with a drizzle of good extra virgin olive oil and a scattering of chopped flat leaf parsley to add color and freshness.

Cultural Background

This dish blends Italian techniques with seasonal American ingredients. The use of tubular pasta with a creamy, cheese enriched sauce reflects Italian comfort traditions while roasted squash is a New World vegetable embraced in autumnal menus across the United States. Combining sausage with a vegetable puree is a practical, flavorful approach seen in many home cooking traditions where available vegetables serve as the sauce base.

Seasonal Adaptations

In late autumn and winter use fresh roasted squash for sweetness. In spring swap squash for roasted asparagus puree and add lemon zest for brightness. In summer use roasted zucchini for a lighter sauce and toss in fresh basil. For holiday gatherings increase the Parmesan and add a pinch of nutmeg to echo seasonal spices. Small changes in herbs and roasting time help tailor the dish to whatever is in season.

Meal Prep Tips

Roast the squash ahead and store in the refrigerator for up to three days. Cook and cool the pasta separately and store in a sealed container. When ready to serve, warm the puree with cream and toss with quickly reheated pasta and sausage. Portion into containers for lunches and refrigerate. Reheat gently to preserve texture and stir in a splash of cream or water to refresh the sauce before serving.

This creamy butternut squash pasta with sausage and spinach is one of those dishes that invites personalization while delivering dependable comfort. Whether you keep it simple for family weeknights or dress it up for guests, it rewards attention to roasting, seasoning, and finishing with warm olive oil and fresh cheese. Try it as written and then make it your own.