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Wash, dry, and trim zucchini; run a vegetable peeler along the length of the zucchini to make ribbons. Place in a medium bowl and set aside.
Preheat a large skillet over medium-high heat.
While the skillet heats up, peel, halve, and small dice onion; peel and mince garlic.
Once the skillet is hot, add onion, garlic, sausage, and spices. Cook, breaking the meat apart with a spoon, until browned and crumbly, 4-5 minutes.
When the sausage is done, add zucchini noodles, tomato sauce, and cream to the skillet. Continue to cook, stirring occasionally, until zucchini noodles are soft and sauce has thickened, 3-4 minutes more. Remove from heat.
Meanwhile, finely grate Parmesan.
To serve, divide skillet between plates or bowls. Top with Parmesan and enjoy!