Fettuccine Alfredo with Italian Sausage: A Lighter Take on the Classic Creamy Pasta

This Fettuccine Alfredo with Italian Sausage is one of our most-requested dinners. This creamy pasta combines tender fettuccine, savory Italian sausage, and earthy mushrooms in a velvety Alfredo sauce that tastes just as rich as the original but is actually much better for you!

The best part? It only takes about 30 minutes to make from start to finish, and you won’t believe it doesn’t have any heavy cream or butter.

Why I Love This Recipe

I first created this sausage fettuccine Alfredo when I was flipping through Food Network Magazine and saw a pasta dish that looked amazing but was loaded with cream and butter. My heart and my thighs definitely didn’t need all those calories, but I was craving that creamy comfort food! So I got creative in my kitchen.

Now, I’ll be honest – the first time I made it, my kitchen looked like a tornado had hit it. My husband John walked in and thought we’d been robbed! But once we tasted it, we both agreed the mess was totally worth it.

What makes this recipe so special is that it delivers all the creamy, indulgent flavor of traditional Fettuccine Alfredo but without the guilt. I use a secret ingredient (arrowroot powder) to create that silky sauce instead of heavy cream and butter. Even my Italian husband, who grew up on the real deal, loves this version and never complains about missing the extra calories.

What Makes This Alfredo Sauce Better for You

Traditional Fettuccine Alfredo is honestly one of the unhealthiest pasta dishes you can eat. A typical restaurant serving has around 1,200 calories, 75 grams of fat, and 47 grams of saturated fat – that’s more than half your daily recommended intake in just one meal!

My lighter Alfredo sauce doesn’t use a single drop of butter or heavy cream, making it much lower in calories and fat while still being incredibly creamy and delicious. Instead of a butter-and-flour roux or heavy cream, I use arrowroot powder mixed with chicken stock to create that signature velvety texture.

The result is a gluten-free, lower-calorie sauce that tastes just as good as the original. You’re still getting that rich, comforting Alfredo flavor from the Parmesan cheese, but without all the extra fat and calories weighing you down.

Key Ingredient Notes

While you’ll find the full ingredient list in the recipe card below, I wanted to highlight a few important ingredients:

Arrowroot Powder: This is the secret ingredient that makes this recipe so much healthier! It comes from a tropical plant and works as a natural thickener without adding calories or fat. It creates that creamy, smooth texture you love in Alfredo sauce without needing a butter-and-flour roux or heavy cream. You can find it in the baking aisle or natural foods section of most grocery stores. If you can’t find it, cornstarch will work in a pinch.

Italian Sausage: I usually use turkey Italian sausage to keep the calories even lower, but pork Italian sausage works beautifully too. Make sure to choose a flavored Italian sausage (not breakfast sausage) – I love the ones with herbs and garlic already mixed in. If you need a gluten-free version, just check the sausage label.

Mushrooms: Any mushrooms work great! I usually grab baby bella (cremini) mushrooms because they have wonderful flavor, but white button mushrooms or even sliced portobello mushrooms are delicious too. The key is to wipe them clean with a dry paper towel or mushroom brush instead of washing them – mushrooms soak up water like little sponges and that can make your sauce watery.

Fresh Parmesan Cheese: Please use freshly grated Parmesan cheese for this recipe, not the powdered stuff in the green can. Fresh Parmesan melts so much better and gives you that authentic Alfredo flavor. I buy a block of Parmigiano-Reggiano and grate it myself – it makes a huge difference!

Chicken Stock: Use a good-quality chicken stock or broth. Low-sodium works great because you can control the salt level yourself. The chicken stock becomes the base of your Alfredo sauce, so better stock means better flavor.

Whole Wheat Fettuccine: I like using whole wheat fettuccine to add extra fiber and nutrients, but regular fettuccine works perfectly too. If you need a gluten-free option, use your favorite gluten-free pasta – just make sure your sausage is also gluten-free!

Pro Tips for Making Perfect Fettuccine Alfredo with Italian Sausage

Before you head to the recipe card, here are some helpful tips I’ve learned from making this dish many times:

Get Organized First: Measure out your arrowroot powder, chop your onions and mushrooms, mince your garlic, and grate your cheese before you turn on the stove. The recipe moves quickly once you start, so being ready makes it so much easier!

Use Medium-Low Heat for the Sauce: When you add the arrowroot mixture to create your Alfredo sauce, keep the heat at medium-low. This lets the sauce thicken gradually and prevents it from getting lumpy or too thick too fast.

Don’t Wash Your Mushrooms: Just wipe them clean with a dry paper towel or brush. Mushrooms absorb water easily, and wet mushrooms will release moisture into your sauce and make it watery.

Save Some Pasta Water: Before you drain your fettuccine, scoop out about a cup of the starchy pasta cooking water. If your sauce gets too thick when you combine everything, you can add a splash of pasta water to loosen it up to the perfect consistency.

Cook Your Pasta Al Dente: Since the pasta will continue cooking slightly when you mix it with the hot sauce, cook it just until al dente (still has a little bite to it). This prevents mushy pasta and helps it hold up better in the creamy sauce.

Mix the Arrowroot Powder Completely: When you’re combining the arrowroot powder with water, stir it really well until it’s totally smooth with no lumps. A fork or small whisk works great for this.

How to Make This Sausage Fettuccine Alfredo

Making this healthier Fettuccine Alfredo with Italian Sausage is easier than you might think! Here’s how it all comes together:

1. Get your pasta water boiling and cook your fettuccine according to package directions until al dente (about 10-12 minutes). While the pasta cooks, you’ll make the sauce.

2. Heat a drizzle of olive oil in a large skillet over medium heat. Add your diced onions and chopped mushrooms and cook for about 3 minutes until the onions start to soften. Add the minced garlic and cook for another 30 seconds until fragrant. Transfer the vegetable mixture to a bowl and set aside.

3. Using the same skillet, cook your Italian sausage, breaking it up into bite-sized pieces as it browns. Cook until the sausage is nicely browned and cooked through.

4. Add the chicken stock to the skillet with the cooked sausage. In a small cup or bowl, mix the arrowroot powder with 1/4 cup of water, stirring until completely smooth. Pour this mixture into the skillet and stir constantly over medium-low heat. You’ll see the sauce start to thicken within a minute or two – it’s like magic!

5. Once the sauce has thickened, stir in about 2/3 of your grated Parmesan cheese until it melts into the sauce. Add back the cooked mushrooms, onions, and garlic and stir everything together.

6. Drain your cooked fettuccine and add it right into the skillet with the sauce. Toss everything together gently until all the pasta is coated in that creamy Alfredo sauce. If it seems too thick, add a splash of the reserved pasta water.

7. Taste and add salt and pepper as needed. Divide among plates, garnish with the remaining Parmesan cheese and chopped fresh parsley if you like, and serve immediately while it’s hot and creamy!

Storage and Leftovers

This sausage fettuccine Alfredo will keep well in the refrigerator for up to 5 days stored in an airtight container.

To reheat, I recommend adding a couple tablespoons of chicken broth or a small pat of butter to a skillet and gently reheating the pasta over medium-low heat. This helps bring back that creamy texture. You can also reheat individual portions in the microwave – just add a splash of chicken broth or water and heat in 30-second intervals, stirring in between.

I don’t recommend freezing this dish because Alfredo sauce can separate and become grainy when frozen and thawed. It’s best enjoyed fresh or within a few days of making it.

For make-ahead convenience, you can prep the vegetables ahead of time and store them in the fridge. You can also brown the sausage a day in advance. When you’re ready to eat, just make the sauce and cook the pasta fresh – it only takes about 15 minutes!

Variations to Try

Extra Veggie Boost: Sneak in more vegetables by adding steamed broccoli florets, diced red bell peppers, or sun-dried tomatoes along with the mushrooms and onions. Summer squash like zucchini or yellow squash also work beautifully!

Spicy Sausage Fettuccine Alfredo: Use hot Italian sausage instead of sweet, or add a pinch of red pepper flakes to the sauce for some heat.

Chicken Alfredo Version: Swap the Italian sausage for sliced, cooked chicken breast if you prefer poultry. Season the chicken with Italian herbs for similar flavor.

Lower Carb Option: Use spiralized zucchini noodles or shirataki noodles instead of regular fettuccine for an even lighter version.

Gluten-Free Fettuccine Alfredo: Use your favorite gluten-free pasta and make sure to buy gluten-free Italian sausage. The Alfredo sauce is naturally gluten-free when made with arrowroot powder!

Even Lighter Version: Use turkey sausage and reduce the Parmesan cheese to 3/4 cup instead of a full cup to cut even more calories.

Spinach Addition: Stir in a few handfuls of fresh spinach leaves at the end – they’ll wilt right into the hot pasta and add color and nutrients.

Frequently Asked Questions

Can I make this Fettuccine Alfredo ahead of time? While this dish is best served fresh, you can prep components ahead. Brown the sausage and sauté the vegetables up to a day in advance, then store them in the fridge. When you’re ready to eat, make the sauce and cook the pasta fresh – it only takes about 15 minutes!

What can I use instead of arrowroot powder? Cornstarch is the best substitute for arrowroot powder. Use the same amount and mix it with water the same way. The texture will be slightly different but still delicious.

How do I keep the sauce from getting too thick? Save some pasta cooking water before draining your fettuccine. If the sauce gets too thick when you combine everything, add the pasta water a tablespoon at a time until you reach your desired consistency.

Can I use a different type of pasta? Absolutely! While fettuccine is traditional for Alfredo, penne, rigatoni, or even spaghetti would work well. Just cook according to the package directions.

Is this recipe really healthier than regular Fettuccine Alfredo? Yes! Traditional Fettuccine Alfredo has about 1,200 calories and 75 grams of fat per serving. This version has significantly fewer calories and fat because it doesn’t use heavy cream or butter, while still delivering that creamy, satisfying texture you love.

Can I make this dairy-free? The Parmesan cheese is what gives this dish its Alfredo flavor, so it’s hard to make truly dairy-free while keeping it authentic. However, you could try nutritional yeast or a dairy-free Parmesan alternative, though the flavor will be different.

Give This Recipe a Try!

This Fettuccine Alfredo with Italian Sausage is a complete meal on its own, but it pairs wonderfully with a simple side salad dressed with balsamic vinaigrette and some crusty Italian bread.

The combination of creamy sauce and hearty sausage makes it so satisfying, while the fact that it’s actually good for you makes it perfect for regular weeknight dinners. I promise you won’t miss all that heavy cream and butter one bit!

Please let me know in the comments if you try it and what you think! If you love this recipe, I’d be so grateful if you’d leave it a five-star ⭐️⭐️⭐️⭐️⭐️ rating below. Your reviews help other home cooks find these recipes!

Related Recipes You’ll Love

If you enjoy this Fettuccine Alfredo with Italian Sausage, I bet you’ll also love some of my other healthier pasta recipes!

My Healthier Shrimp Fettuccine uses a similar lighter sauce technique but with seafood for a delicious twist. For another great sausage and pasta combination, try my Tortellini Soup with Sausage which is perfect for cozy nights. And if you love creamy pasta, my Creamy Shrimp and Spinach Pasta is always a crowd-pleaser!

For more Italian comfort food favorites, check out my Italian Sausage and Potatoes or my Chicken Asparagus Pasta.

Did you enjoy this recipe? Don’t forget to pin it for later and follow me on Pinterest for more delicious recipes like this one!

Originally published: June 18, 2021. Updated: January 25, 2026 – Enhanced with more detailed instructions, tips, and serving suggestions. No changes were made to the recipe.