This creamy pumpkin pasta combines the earthy sweetness of pumpkin puree with rich cream and savory Parmesan cheese, creating a comforting fall-inspired dish. The sauce is silky smooth with warm spices like nutmeg and sage, perfectly coating every strand of pasta for a restaurant-quality meal that's ready in under 30 minutes.
Bring a large pot of salted water to a boil and cook pasta according to package directions until al dente. Reserve 1/2 cup pasta water before draining.
While pasta cooks, melt butter in a large skillet over medium heat. Add minced garlic and sauté for 1 minute until fragrant.
Stir in pumpkin puree, heavy cream, nutmeg, and sage. Simmer for 3-4 minutes, stirring occasionally until sauce is smooth and heated through.
Remove from heat and stir in grated Parmesan cheese until melted. Season with salt and pepper to taste.
Add drained pasta to the sauce, tossing to coat. Add reserved pasta water as needed to reach desired consistency.
Serve immediately topped with extra Parmesan, fresh sage leaves, pumpkin seeds, and red pepper flakes if desired.
Notes
Use pure pumpkin puree, not pumpkin pie filling which contains added sugars and spices.
Fresh pumpkin can be substituted: roast 1 lb pumpkin and puree until smooth.
For a lighter version, replace heavy cream with half-and-half or whole milk (sauce will be thinner).
Add cooked Italian sausage or crispy pancetta for a non-vegetarian option.
Sauce can be made ahead and refrigerated for up to 3 days; reheat gently and add pasta water to thin.
Leftovers keep for 3-4 days refrigerated in an airtight container; reheat with a splash of cream or milk.
For extra depth, add 1/4 teaspoon cinnamon or a pinch of cayenne pepper.
Brown butter instead of regular butter adds a nutty, caramelized flavor.
Best pasta shapes: fettuccine, penne, rigatoni, or farfalle - anything that holds sauce well.
To crisp fresh sage for garnish, fry leaves in butter for 30 seconds until crispy.