Creamy Sausage Tortellini Bake with Spinach and Tomatoes

Prep Time: 20 minutes
Cook Time: 35-40 minutes
Total Time: 55-60 minutes
Servings: 8 generous portions
Difficulty: Easy to Intermediate

This Creamy Sausage Tortellini Bake is the ultimate comfort food casserole. Tender cheese tortellini mingles with savory crumbled Italian sausage, wilted fresh spinach, juicy diced tomatoes, and a luscious creamy sauce infused with garlic, herbs, and a touch of spice. Everything bakes together under a golden blanket of mozzarella and Parmesan, creating bubbly edges and gooey cheese pulls in every scoop. It’s a one-dish wonder that feels indulgent yet comes together without too much fuss—perfect when you want something hearty that tastes like you spent hours in the kitchen.

Whether you’re feeding a crowd, looking for leftovers that reheat beautifully, or just craving cozy Italian-inspired flavors, this bake delivers. The combination of textures—chewy tortellini, tender sausage crumbles, silky sauce, and vibrant greens—makes every bite satisfying.

Ingredients

For the sausage and base:

1.5 lbs (about 680g) mild or hot Italian sausage (bulk, or remove casings from links) – mild for family-friendly, hot for extra kick
1 large yellow onion, finely diced (about 1.5 cups)
4-5 large garlic cloves, minced (or 1.5 tablespoons pre-minced)
1 teaspoon olive oil (if your sausage is very lean)

For the sauce and veggies:

1 (28 oz / 794g) can crushed tomatoes (fire-roasted for deeper flavor, or plain)
1 (14.5 oz / 411g) can diced tomatoes, drained lightly (or use fresh diced Roma tomatoes in summer)
1.5 cups heavy cream (or half-and-half for a lighter version)
1 cup low-sodium chicken broth (helps thin and add savory depth)
2 teaspoons dried Italian seasoning (or a mix of dried basil + oregano)
½ teaspoon crushed red pepper flakes (adjust to taste for heat)
½ teaspoon smoked paprika (optional, for subtle smokiness)
Salt and black pepper, to taste (start with ½ teaspoon each)
5-6 cups fresh baby spinach (roughly chopped if leaves are large)

Pasta and cheese:

20-25 oz (about 567-700g) fresh or frozen cheese tortellini (refrigerated section; three-cheese or spinach-cheese varieties work great)
3 cups shredded mozzarella cheese, divided (low-moisture for best melt)
1 cup grated Parmesan cheese, divided (freshly grated preferred)
½ cup ricotta cheese (optional, for extra creaminess—stir into sauce or dollop)

For finishing:

Fresh chopped parsley or basil (about ¼ cup), for garnish
Extra Parmesan or red pepper flakes, for serving

Step-by-Step Instructions

Preheat your oven and prep the dish
Set your oven to 375°F (190°C). Lightly grease a 9×13-inch (23×33 cm) baking dish with cooking spray or a thin layer of olive oil. This prevents sticking and makes cleanup easier. Set the dish aside while you build the components.
Brown the sausage
In a large, deep skillet or Dutch oven (at least 5-6 quarts), heat over medium-high. Add the Italian sausage, breaking it up with a wooden spoon or spatula. Cook for 7-9 minutes, stirring frequently, until browned and no longer pink. If there’s excess grease (common with sausage), carefully drain most of it, leaving about 1-2 tablespoons for flavor. This fat will help sauté the vegetables and carry the seasonings.
Build the aromatic base
Reduce heat to medium. Add the diced onion to the sausage. Cook 4-5 minutes until softened and translucent. Stir in the minced garlic and cook another 60-90 seconds until fragrant—be careful not to burn the garlic, as it turns bitter quickly. If the pan looks dry at any point, drizzle in that teaspoon of olive oil.
Develop the sauce
Pour in the crushed tomatoes and diced tomatoes. Stir to combine, scraping up any browned bits from the bottom of the pan (those bits = flavor gold). Add the Italian seasoning, crushed red pepper flakes, smoked paprika (if using), salt, and black pepper. Bring the mixture to a gentle simmer and let it bubble for 5-7 minutes. This step concentrates the tomato flavor and marries the spices with the sausage.
Make it creamy
Slowly pour in the heavy cream and chicken broth while stirring constantly. The sauce will turn a beautiful rosy-orange color. Bring back to a gentle simmer (do not boil hard, or the cream may separate). Taste and adjust seasoning—add more salt, pepper, or a pinch of sugar if the tomatoes taste too acidic. Simmer 4-5 minutes to let everything meld.
Add the spinach
Stir in the fresh spinach a few handfuls at a time. It will look like a mountain at first, but it wilts down quickly (2-3 minutes). Once wilted and bright green, remove the pan from heat. If using ricotta, stir it in now for ultra-creamy pockets, or reserve to dollop later.
Combine with tortellini
Add the uncooked tortellini directly to the sauce (fresh/refrigerated tortellini works best here—no need to pre-boil). Gently fold everything together so the pasta is coated. The residual heat and moisture from the sauce will start softening the tortellini. If the mixture looks too thick, add a splash more broth or cream. If too thin, it will thicken during baking.
Assemble the bake
Transfer the entire mixture to your prepared 9×13 baking dish, spreading evenly. Sprinkle 2 cups of the mozzarella and ¾ cup Parmesan over the top. For extra cheesy layers, add another cup of mozzarella midway through baking (see step 9). Cover loosely with foil (spray the foil with cooking spray to prevent cheese sticking).
Bake to perfection
Bake covered for 20 minutes. Remove foil, sprinkle the remaining 1 cup mozzarella and ¼ cup Parmesan. Bake uncovered another 10-15 minutes until the cheese is melted, golden, and bubbly around the edges. If you want extra browning, switch to broil for the final 1-2 minutes (watch closely to avoid burning).
Rest and serve
Let the casserole rest 5-10 minutes before serving. This allows the sauce to set slightly and makes scooping easier. Garnish generously with chopped fresh parsley or basil. Serve hot with crusty garlic bread, a simple green salad, or steamed vegetables.

Tips for Success

Pasta choice: Fresh refrigerated tortellini cooks perfectly in the sauce without pre-boiling. Frozen works too but may need 5-10 extra minutes baking time. Avoid dried tortellini here—it requires too much liquid.
Make-ahead: Assemble up to step 8, cover tightly, and refrigerate up to 24 hours. Add 10-15 minutes baking time if starting cold.
Freezing: Bake fully, cool completely, portion, and freeze up to 2-3 months. Reheat in oven at 350°F covered until hot (thaw overnight first for best texture).
Lighter version: Swap heavy cream for half-and-half or evaporated milk; use turkey Italian sausage; add extra veggies like zucchini or bell peppers.
Spice level: Start mild and let individuals add red pepper flakes at the table.
Cheese variations: Mix in provolone, fontina, or asiago for different melt and flavor profiles.
Vegetarian twist: Replace sausage with plant-based crumbles or sautéed mushrooms + fennel seeds for similar savoriness.

Common Questions & Troubleshooting

Sauce too thin after baking? Next time, simmer longer on stovetop before transferring, or uncover for the full bake time.
Tortellini still firm? Use fresh (not frozen) and ensure plenty of liquid in the sauce.
Too greasy? Drain sausage thoroughly and use leaner varieties.
Want more veggies? Double the spinach, or stir in chopped kale, zucchini, or roasted red peppers.

This Creamy Sausage Tortellini Bake is more than just dinner—it’s the kind of meal that fills the house with inviting aromas and brings everyone to the table smiling. The cheesy top, creamy interior, and balanced flavors of sausage, tomato, and greens make it endlessly craveable. Enjoy, and feel free to tweak it to your family’s tastes!