Meatball Fettucine Recipe

Soak breadcrumbs

Place the Italian breadcrumbs in a small bowl and pour the milk over them. Let sit 5 minutes until absorbed.

Mix meatball ingredients

In a large mixing bowl combine ground beef, ground pork, soaked breadcrumbs, grated Parmesan, egg, garlic powder, onion powder, dried parsley, salt, and black pepper. Use your hands or a spoon and mix until just combined; avoid overmixing to keep meatballs tender.

Form meatballs

Portion the mixture into 8 equal portions and roll into tight 1 1/4 to 1 1/2-inch meatballs. Place on a lined tray and chill in the refrigerator for 15 minutes to firm up (optional but helps them hold shape).

Brown and finish meatballs

Heat 2 tbs olive oil in a large skillet over medium heat. Add meatballs in a single layer, not overcrowding; brown on all sides about 8 minutes total, turning gently. They do not need to be fully cooked through — they will finish cooking in the sauce. Remove browned meatballs to a plate and set aside.

Cook pasta

Bring a large pot of salted water to a rolling boil. Add the fettucine and cook according to package instructions until al dente (usually 8–10 minutes). Reserve 1 cup of pasta cooking water, then drain the pasta and set aside.

Sauté aromatics

While pasta cooks, heat 2 tbs olive oil and 1 tbs butter in a wide sauté pan over medium heat. Add the diced onion and cook until translucent, 4–5 minutes. Add the minced garlic and cook 30–45 seconds until fragrant.

Build sauce

Stir in the tomato paste and cook 1 minute. Add the crushed tomatoes and chicken stock, stir to combine. Add dried oregano, dried basil, red pepper flakes, 1 tsp salt, and 1 tsp black pepper. Bring to a gentle simmer and cook uncovered 8–10 minutes to allow flavors to meld and sauce to reduce slightly.

Add cream and finish

Reduce heat to low and stir in the heavy cream and 3 tbs grated Parmesan. Simmer 2–3 minutes until the sauce is creamy and cohesive. Taste and adjust seasoning — add additional salt if needed. If sauce is too thick, stir in reserved pasta water a few tablespoons at a time to reach desired consistency.

Finish meatballs in sauce

Return the browned meatballs to the pan with the sauce, nestling them into the liquid. Cover and simmer gently 8–10 minutes, or until meatballs reach an internal temperature of 160°F (71°C) and are cooked through.

Toss pasta with sauce

Add the drained fettucine directly to the sauce and toss gently to coat. If needed, add up to 1/2 cup reserved pasta water to loosen the sauce and help it cling to the pasta. Stir in chopped parsley (2 tbs) and adjust seasoning.

Preheat a grill or grill pan over medium-high heat. Brush the Italian sausage links lightly with 1 tsp olive oil. Grill the sausages, turning occasionally, until browned and cooked through, about 10–12 minutes (internal temperature 160°F/71°C). Remove from heat and slice each link on a bias into 1/4-inch slices, or leave whole to serve alongside.

Divide the tossed fettucine among 4 plates (serves 4). Arrange two house meatballs on top of each portion and place the sliced or whole grilled Italian sausage alongside or on top as desired.

Sprinkle each plate with extra grated Parmesan (about 2 tbs per plate) and garnish with chopped parsley or basil. Serve immediately.