In a large pot or deep skillet, heat over medium heat and add the Italian sausage. Cook for about 5–7 minutes, breaking it apart with a wooden spoon until browned and cooked through. Drain any excess fat.

Add chopped onion and minced garlic to the pot with the cooked sausage. Sauté for 3–4 minutes until the onions turn translucent and fragrant, stirring frequently.

Stir in the canned tomatoes, fresh basil, oregano, and heavy cream into the pot. Bring to a gentle simmer and cook for about 5 minutes until it thickens slightly.

Add the uncooked rigatoni directly into the pot, ensuring the pasta is submerged in the sauce. Cover and cook for about 10–12 minutes, stirring occasionally.

Once the pasta is cooked, remove from heat and stir in freshly grated Parmesan cheese until melted and creamy. Adjust seasoning with salt and pepper.

Ladle the creamy rigatoni into bowls and garnish with fresh basil leaves. Serve immediately.