Step 1

Make a shallow cut in the sausage skin and remove it from the (uncooked) mild Italian sausage and cut into 4 pieces each.

Step 2

Shape each piece into a meatball, using the palms of your hands.

Step 3

In a large pan or skillet or Dutch oven, heat about one tablespoon of vegetable oil until it sizzles. 

Step 4

Add meatballs and brown on all sides for about 5 minutes. Stir occasionally to get all sides.

Step 5

Then remove the meatballs and set aside. It’s okay if they’re not fully cooked through at this point. They’ll cook through later when being put back in with the sauce. 

Step 6

Add the butter to the same pan and stir in the onion. If there are any meatball bits and pieces stuck to the bottom of the pan, great, scrape them off with a wooden spoon. 

Step 7

Season with 1/2 tsp kosher salt and 1/4 tsp freshly ground black pepper. 

Step 8

Cook onions for about 5 minutes.

Step 9

Next, add minced garlic, tomato paste, anchovy paste (if using), and oregano, and stir well for 2 minutes. 

Step 10

Add the can of tomatoes, 3 cups of beef stock, and pasta, and bring to a boil. 

Step 11

Add meatballs back into the pot and stir occasionally. 

Step 12

Now add the uncooked pasta. It will take about 10-12 minutes (depending on the pasta) to finish the dish. 

Step 13

Add a cup of shredded Parmesan (or any shredded cheese you like) about 5 minutes before you think the pasta is ready. 

Step 14

Divide onto plates and garnish with some more shredded cheese and roughly chopped flat leaf Italian parsley.