Do I need to use heavy cream?
Heavy cream is the most forgiving and least likely to curdle. If you want a lighter option, use half-and-half, just keep the heat lower and do not boil the sauce. You can also use whole milk, but the sauce will be thinner. A little extra Parmesan helps.
Should I use mild or hot Italian sausage?
Either works. Mild gives you a family-friendly, cozy vibe. Hot makes the whole dish taste louder in a good way. If you have hot sausage lovers and mild-only folks at the table, use mild sausage and add red pepper flakes to your bowl.
Can I make this without sun-dried tomatoes?
Yes. Swap in 1 to 1 1/2 cups halved cherry tomatoes. Let them blister in the skillet for a few minutes before adding garlic. Because sun-dried tomatoes are more concentrated and tangy, you may want an extra pinch of salt and a tiny splash of lemon juice or vinegar at the end to mimic that punch. Taste and adjust.
How do I keep the sauce from getting greasy?
Greasiness is mostly a fat-to-liquid situation, so you have a few easy levers. Spoon off or blot excess rendered fat after browning the sausage, then build the sauce with what is left. Keep the sauce at a gentle simmer, not a rolling boil, and use reserved pasta water gradually to help everything emulsify. Stir the Parmesan in fully before serving so the sauce turns smooth and glossy instead of separating.
Can I use a different pasta shape?
Absolutely. Penne, rigatoni, fusilli, and shells all catch the sauce well. If you use long pasta like fettuccine, toss it thoroughly with pasta water so everything gets glossy and coated. Cook time will vary by shape, so follow the package and pull it when it is just al dente.