Step 1

Bring the pasta water to a boil.

Step 2

While the water is coming to a boil, heat the olive oil in a large skillet or sauce pan. Add the onion and cook 4-5 minutes until it begins to soften. Add the garlic and cook for 30 seconds until fragrant.

Step 3

Add the sausage and cook 5-6 minutes, breaking it up as you go, until browned. Add the cauliflower and stir. Press the cauliflower down into the pan and let cook for 5-6 minutes, until cauliflower begins to brown.

Step 4

Add the tomatoes, Italian seasoning, red pepper flakes, salt, and pepper. Bring to a simmer and let simmer for 15 minutes or until cauliflower is just tender.

Step 5

Meanwhile cook the pasta until al dente. Drain and add to the cauliflower and sausage sauce. Season with salt and pepper if needed. Top with Parmesan cheese.