One Pot Creamy Tomato Pasta Sauce and Meatballs is spaghetti and meatballs meets vodka rigatoni, but it's all made neatly in one pot! Tender meatballs made with Italian sausage are seared until crusty and golden brown and then cooked with a creamy tomato sauce and adorable pipette shells. The perfect Sunday supper!
Add the Italian sausage, 3/4 teaspoon salt, egg, and 1/4 cup parmesan cheese to a medium bowl. Sprinkle the bread crumbs on top and then cover in the milk. Make sure the milk soaks into the breadcrumbs. This creates, light, tender meatballs!
Use your hands to gently mix the ingredients together just until they are combined. Do not over mix! Use a small cookie scoop to form the meatballs. Wet hands and roll into balls (this helps to prevent sticking).
Heat a large skillet with high sides to a medium-high heat. Add olive oil. Swirl to coat pan. Add meatballs. Sear until meatballs are crusty and brown on all sides. Try not to turn the meatballs until they release easy from the pan. Once all the meatballs are brown, remove them from the pan and transfer to a plate.
Open up the can of tomatoes while the meatballs cook and use hands or kitchen shears to crush them.
Drain all but a tablespoon of the remaining fat. Reduce the heat to medium-low and add the onion, garlic, and 1/4 teaspoon of salt. Saute until slightly softened, about 2-3 minutes. Add in vodka. Use a wooden spoon to scrape up all the brown bits from the bottom of the pan. Bring to a boil and reduce to a simmer. Simmer until reduced by half.
Add in crushed tomatoes, tomato paste, water, parmesan cheese rind, sugar, basil, and remaining 1 1/4 teaspoons salt. Stir to combine. Add in pasta. Stir to combine. Bring to a boil and reduce to a simmer. Cover and continue to simmer until the pasta is just under aldente, about 10 minutes. Stir every few minutes to prevent the pasta noodles from sticking to the bottom of the pan.
Add the meatballs and cream to the pan. Again, bring to a boil and reduce to a simmer. Simmer uncovered until the meatballs are cooked through and the pasta is aldente or cooked to your liking. Stir in remaining 1/4 cup of parmesan cheese. Season to taste with salt and pepper.