In a large pot or Dutch oven, heat a splash of olive oil over medium heat. Add Italian sausage, breaking it into smaller pieces as it cooks, and sauté for about 5–7 minutes until browned and cooked through. Toss in chopped onions and continue stirring for another 3–4 minutes until the onions become translucent and fragrant.

Reduce the heat to low and add minced garlic to the pot, sautéing for about 1 minute until aromatic but not browned.

Pour in the canned tomatoes, along with oregano, basil, and a pinch of red chili flakes. Bring to a gentle simmer and allow the flavors to meld together for about 5 minutes.

Once the sauce is simmering, pour in the heavy cream, stirring continuously to achieve a velvety consistency. Gradually mix in grated Parmesan cheese until fully melted.

Add the rigatoni directly into the sauce, stirring gently to fully submerge. Cover and cook for about 10–12 minutes, stirring occasionally.

Once the pasta is cooked, remove the pot from heat and let it sit for a couple of minutes. Serve warm, garnished with basil leaves and a drizzle of olive oil.