In a large pot, heat a drizzle of olive oil over medium heat. Add the Italian sausage, breaking it apart with a wooden spoon, and cook for about 5-7 minutes or until browned and no longer pink.

As the sausage cooks, add in the chopped onion and minced garlic, sautéing until the onion is translucent and fragrant, roughly 3-4 minutes.

Stir in the canned tomatoes along with the heavy cream, fresh basil, and dried oregano. Reduce the heat to low, allowing the sauce to gently simmer for about 5-10 minutes.

While your sauce simmers, bring a large pot of salted water to a rolling boil. Add the rigatoni and cook according to package instructions, typically around 10-12 minutes.

Once the pasta is cooked and drained, add it directly to the creamy sauce in the pot. Toss the rigatoni gently to ensure every piece is well coated.

To finish, plate the creamy Italian sausage rigatoni and generously garnish with freshly grated Parmesan cheese and more basil if desired.