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Few things are tastier and more comforting than mac and cheese, but this one’s a game changer. Sausage and cheese rotini. This dish has a creamy tomato cheese sauce, flavorful sausage and then it’s topped with even more cheese; that’s what we call elevated comfort food!

If you are plagued with picky eaters in the family (don’t worry, we still love them) or are just looking for a way to reinvent a classic, this recipe is the perfect choice! While you’ll have several pots going on the stove at once, the separate components come together quickly and the rave reviews you’ll get from your third-party food critics (children) will have you adding this dish to your weekly rotation!

Rotini Sausage Casserole

Serves 6


  • 1 pound (2 cups) rotini (or macaroni)
  • 3/4 pound ground pork sausage
  • 1 (14 oz) can crushed tomatoes, drained
  • 1 cup Parmesan cheese, grated
  • 1 cup cheddar cheese, grated; plus more for topping
  • 1/2 cup heavy cream
  • 3 tablespoons butter
  • 1-2 tablespoons all-purpose flour
  • 1 teaspoon sugar
  • 1/4 teaspoon nutmeg
  • salt and pepper, to taste
  • water for boiling


  1. Preheat oven to 350º F.
  2. Bring a large pot of salted water to boil and cook pasta until just al dente. Drain and set aside.
  3. In a large pan over medium-high heat, cook sausage until nicely browned and no longer pink.
  4. Drain fat and add tomatoes. Add in sugar, stir well and reduce heat to low. Season with salt and pepper.
  5. In a sauce pan, melt butter over medium-low heat and add in 1-2 tablespoons of flour. Mix continuously to break up flour and create roux.
  6. Once roux has thickened, add in heavy cream and nutmeg and bring to a boil.
  7. Reduce to a simmer and add parmesan and cheddar cheese. Stir until cheeses have melted. Taste and adjust seasoning if necessary.
  8. After cheeses have fully melted, pour cream mixture into the tomato sauce and mix together.
  9. Pour pasta into tomato cream sauce, making sure to coat pasta thoroughly with sauce.
  10. Transfer pasta and sauce to an 8×8 or 9×13 baking dish (or individual ramekins). Top pasta with more cheddar cheese, place in oven and bake for 30 minutes.
  11. Let cool for 10 minutes, garnish with basil and enjoy!
Gratin with macaroni, meat, cheese and tomato sauce