Add the peeled and smashed garlic (hit it with the flat side of a knife) to a frying pan with the extra virgin olive oil, then add the diced pumpkin and skinned sausages.
Use a wooden spoon to chop the sausage into small pieces as it cooks.
Let them brown for about 5 minutes and then add salt, black pepper, and the chopped tomatoes, and the water, and simmer for about 20 minutes.
Taste, and adjust the seasonings if needed.
Cook the fusilli:
Cook the pasta in large pot with a plentiful amount of salted water. You can start the pasta cooking when the sauce has about 10 minutes left to save time.
When the pasta is al dente (still a little hard when you bit into it) drain with a slotted spoon and add directly to the frying pan with the sauce.
Toss the pasta with the sauce and serve immediately. You can sprinkle some chopped parsley and Parmigiano or Pecorino cheese, if you desire.
Notes
Always use fresh, organic ingredients for the best results.
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