Mushroom Sausage Fettuccine Alfredo

5 from 1 vote

Tender sautéed mushrooms, sausage, and spinach spruce up this creamy sausage fettuccine alfredo into a luxurious pasta dinner.

Prep Time 20

Cook Time 15

Total Time 35

Servings servings

Calories 540kcal

2 tablespoons vegetable oil, divided
1/2 lb ground sweet Italian sausage
8 oz button or cremini mushrooms, thinly sliced
1-1/2 cups firmly-packed baby spinach
2 medium cloves garlic, minced
2 tablespoons unsalted butter
2 tablespoons all-purpose flour
1-1/2 cups 2% or skim milk
1/2 cup heavy whipping cream
3/4 cup grated Parmesan cheese
12 oz dry fettuccine (cooked according to package instructions until al dente and 1 cup pasta water reserved)
Salt and pepper to taste
Additional grated Parmesan cheese for topping

Heat a Dutch oven or large skillet over medium-high heat, add 1 tablespoon oil, and swirl to coat pan. Add sausage and sauté over medium-high heat until sausage is no longer pink. Use a slotted spoon to transfer sausage to a bowl.
Add remaining 1 tablespoon vegetable oil to pan. Add mushrooms and sauté 3-4 minutes over medium-high heat until mushrooms are nearly tender. Add spinach and garlic and cook 2-3 additional minutes until spinach is wilted Season mushrooms and spinach with salt and pepper to taste and transfer to bowl with sausage.
Melt butter in same pan you used for the mushrooms over medium heat. Whisk flour into butter and cook 1-2 minutes until golden brown.
Slowly begin drizzling in milk and whipping cream, whisking constantly until sauce is smooth. Cook sauce over medium heat, stirring occasionally until sauce is bubbly and thickened. Remove from heat and whisk in Parmesan cheese until melted.
Fold cooked fettuccine, sausage, and mushrooms/spinach into sauce and return to medium heat, cooking 2-3 minutes until pasta is evenly coated, thinning sauce with a few splashes of reserved pasta water as needed. Season pasta with salt and pepper to taste.
Serve fettuccine alfredo warm with additional grated Parmesan cheese on top. Enjoy!

Storing Instructions

Store alfredo in refrigerator up to 6 days.