Sausage Pasta Milano

One of mon mari’s favorite pasta dishes to eat in restaurants is The Macaroni Grill’s Pasta Milano, a rich, bold dish with a garlic cream sauce, chicken, button mushrooms, and sun-dried tomatoes.*  Shortly after we married, I set about to make my own alternative version that I could create at home, with sausage, for added flavor.

This is what I came up with, and it’s a very decadent supper.  We pair it with hot, crusty bread for dipping.  I love to make this recipe on rainy days because the smell envelops the house.  Enjoy!

My Sausage Pasta Milano

Serves 4-6.


2½ cups penne pasta, cooked according to package directions (I prefer penne for this, but you can also use farfalle)

1 roll of breakfast sausage (you can substitute any kind or flavor you like, even turkey sausage)

1 medium onion, diced

2 teaspoons of jarred garlic, minced (about 4 cloves, or to your taste)

1 package button mushrooms, sliced

1½ teaspoon dried oregano

1½ teaspoon dried basil

1/8 cup sun-dried tomatoes in oil, finely chopped (you can also use packaged sun-dried tomatoes without oil)

1 tablespoon of fresh basil paste in a tube (link below)

1/8 cup sliced almonds

pinch of red pepper flakes

2 hand-fuls, very finely grated Parmesan cheese (powdery consistency, available in canisters in grocery stores)

1 jar Alfredo sauce

splash of milk or cream

dash of salt


Brown the sausage in a skillet over medium-high heat, breaking up the sausage into bite-size pieces. Add onion and cook until onion is nearly soft. Add garlic, stir. Add mushrooms. Cook for 5 minutes, or until mushrooms have softened, browned, and reduced. Add dried oregano and basil, stirring to combine. Add in sun-dried tomatoes and a little of the oil if you wish. Cook one minute.

Squeeze basil paste into skillet, stirring to break up the paste and coat the contents of the pan. Add the almonds, cook for 1-2 minutes. Add a pinch of red pepper flakes and stir to incorporate. Add two hand-fuls of very finely grated Parmesan cheese (the almost powdery consistency works best because it thickens the sauce). Stir to coat the sausage mixture with the cheese.

Finally, add the Alfredo sauce and a splash of milk or cream. Stir to combine. Cook until sauce changes color from cream to golden brown, and until flavors combine. Fold the contents of the skillet in with the cooked pasta and a dash of salt in a large bowl and serve with bread.

  • Bonus Tip: Look for the herbs-in-a-tube line of products from Gourmet Garden at grocery stores or check them out at and see the basil paste used in this pasta dish. You can store the tubes in the freezer and use them when you need them. Just thaw the tube for a few minutes and it’s ready! The paste adds a wonderful, rich flavor to everyday recipes.

*I have never seen the recipe or ingredient list for the Romano’s Macaroni Grill chicken version that was my inspiration for this recipe.  I am just speculating as to the ingredients based on restaurant reviews and the taste of the dish.