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Cook the Sausage and Vegetables: Heat a large pot over medium heat. Add the olive oil, then add the diced onion and cook for 7-8 minutes until softened. Add the minced garlic and Italian sausage, cooking for an additional 7-8 minutes until the sausage begins to brown.
Cook the Pasta: While the sausage is cooking, fill a separate large pot with water and bring it to a boil over high heat. Add a generous amount of salt to the water and then add the rigatoni. Cook the pasta according to package instructions, usually around 9-11 minutes for al dente.
Prepare the Sauce: Add the canned tomatoes to the sausage mixture. If using whole tomatoes, blend them in a blender until smooth. Stir in the fresh basil, oregano, red pepper flakes, salt, and pepper. Let the mixture come to a boil, then reduce the heat to let it simmer for 5-7 minutes.
Make It Creamy: Add the heavy cream and 1 cup of Parmesan cheese to the sauce. Stir well and let the sauce simmer on medium-low heat for 5-7 minutes. Taste and adjust seasonings as needed.
Combine Pasta and Sauce: Drain the rigatoni and add it to the sauce, stirring to coat the pasta. If you prefer a less saucy dish, let the sauce simmer for an additional 10 minutes to reduce.
Serve: Plate the pasta and garnish with the remaining ½ cup of Parmesan cheese and fresh basil. Serve immediately and enjoy!