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Cook the bow tie pasta according to the package instructions until al dente. Drain and set aside.
In a large skillet, heat olive oil over medium heat. Add the Italian sausage, breaking it up with a spoon, and cook until browned, about 5-7 minutes.
Add the chopped onion to the skillet and cook for 3-4 minutes until softened. Add the minced garlic and cook for another minute until fragrant.
Pour in the diced tomatoes, heavy cream, and Parmesan cheese. Stir well and bring to a simmer.
Add the cooked pasta to the skillet and toss to coat evenly with the sauce. Season with salt and pepper to taste.
Serve the pasta topped with fresh basil or parsley for garnish.