Heads-up: you’ll need to save pasta water before draining! Bring a large pot of water to boil. Once boiling, add 1 tablespoon salt. Add all the penne pasta and boil, stirring occasionally, until it’s “al dente” according to package directions (lowest time indicated). Before draining, remove 1 cup pasta water. Drain but do not rinse in cold water.
Place a large, cast-iron pan/pot (big enough to hold all the pasta later) over medium-high heat. Drizzle in 1 tablespoon oil. Once oil is hot, add sliced sausage. Let sear, stirring occasionally, until nicely browned (smoked sausage is cooked through, so no need to get to a certain temperature). Use a slotted spoon to transfer to a large bowl, leaving grease behind (If there is more than 1 tablespoon, drain it off). Set sausage aside.
In same pot (don’t wipe it out), add butter and melt over medium-high heat. Once melted, add garlic and sauté for 1 minute. Pour in cream, Cajun seasoning, paprika, oregano, and pepper to taste (I add 1/4 teaspoon). As soon as mixture boils, turn heat down to medium low. Simmer until thickened, about 1–3 minutes (see note 3).
Once thickened, remove from heat. Stir in finely grated Parmesan until melted and sauce is mostly smooth. Dump drained pasta on top of the sauce plus 1/2 cup of reserved pasta water. Return sausage and add optional parsley. Return to heat. Turn to medium and toss gently with tongs until pasta and sauce emulsify (cling together) nicely, about 1 minute. Add additional pasta water if needed (if it’s looking dry/stodgy). Taste and add a pinch of salt if needed.
Remove from heat and serve right away! Garnish plates with fresh parsley plus a sprinkle more of cheese if desired.
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Notes
Note 1: This Cajun seasoning varies from brand to brand. I use McCormick’s® Perfect Pinch Cajun or Tony Chachere’s® Original Creole Seasoning (neither sponsored). You can also make your own Cajun seasoning mix. Whatever you use, add slowly and to taste. Cajun seasoning is often salted, so I don’t add extra salt to the sauce.Note 2: Parmesan cheese makes the biggest difference to the flavor in the recipe. Don't use canned or pre-shredded/grated Parmesan—the sauce won’t work (cheese doesn't melt smoothly, and you’ll be left with a big clump). Instead, use a block of cheese to grate finely on a grater or fine grater. If you’re looking for some extra umph, try Parmigiano Reggiano—it’s incredible in this dish.Note 3: The sauce should be thick enough to coat the back of a wooden spoon. Lift the spoon and immediately trace a line across the back of the spoon with your fingertip. If the line retains a clear track, the sauce is thick enough. If not, the sauce needs to simmer a bit longer.Storage: This dish is best enjoyed immediately. You can store leftovers, but you’ll need to add more heavy cream to loosen the sauce when you reheat the pasta. Because of the pasta and dairy, this dish isn’t good for freezing or thawing.