Twisted pasta strands in a rich Italian sausage ragù that coats every curve. This high protein mediterranean dish is a quick, flavorful family dinner that's ready in 30 minutes.
Heat the olive oil in a large skillet over medium heat until shimmering, then add diced onion and sauté for 2–3 minutes until translucent.
Add Italian sausage, breaking it apart with a spatula; cook on medium-high heat for 5–6 minutes, stirring to prevent burning, until browned.
Stir in minced garlic and red pepper flakes; cook for 1 minute, then immediately add crushed tomatoes and bring the mixture to a gentle simmer.
Simmer the ragù uncovered for 10 minutes, stirring occasionally, until it thickens and the sausage flavors infuse into the sauce; season with salt and black pepper, tasting and adjusting as needed.
While the sauce simmers, cook the gemelli pasta in boiling salted water until just al dente (about 7–8 minutes); reserve ½ cup pasta water and drain.
Add drained gemelli pasta to the sauce, toss over medium heat for 2 minutes, adding reserved pasta water as needed for silky coating; finish with torn basil leaves and serve immediately.