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Step 1
Preheat oven to 350f and set the rack to the middle level. In a large pan saute the sausage over medium heat until browned (about 7-10 minutes), then remove and set aside.
Step 2
Turn the heat down to medium-low. Add in the olive oil and onions and sautee for 3-5 minutes until softened, then add in the garlic and continue to cook for 2-3 minutes longer. If desired, add the optional hot red pepper flakes at this time and cook for 30 seconds.
Step 3
Remove the pan from the heat and stir in the sausage, rice, parsley, Pecorino Romano, half the mozzarella cheese, and a 1/2 cup of marinara sauce. Mix together well and set stuffing aside.
Step 4
Pour the marinara sauce a 1/2-inch high into a large baking dish and add the water. Mix together.
Step 5
Season the interior of each pepper with salt and pepper. Stuff the peppers and place them lying flat in the baking dish. Add a thin layer of sauce to the top of the peppers and sprinkle the remaining mozzarella cheese on top.
Step 6
Puncture a hole with a knife or toothpick into the bottom of each pepper. This will prevent the peppers from bursting. Cover the baking dish with parchment paper then aluminum foil tightly and bake the peppers for 60 minutes.
Step 7
Remove the foil and check the peppers. If they are sufficiently tender you can remove them from the oven or continue cooking for 10-15 minutes longer if necessary. If you like you can broil the top for 30-60 seconds before serving, but watch carefully. Enjoy!