Cook the pasta in a large pot of boiling salted water until al dente, following package instructions. Drain and set aside.
Heat the large skillet over medium heat, add the sausage, and cook until browned and cooked through, breaking it apart with a spoon for even crumbling. This should take about 5–7 minutes, and you should see a deep golden brown color.
Add the sliced bell peppers to the skillet with the sausage and sauté until the peppers are tender and slightly caramelized, about 5 minutes. The peppers should be vibrant in color and slightly softened.
Stir in the minced garlic and cook until fragrant, about 30 seconds. Then pour in the cream, stirring continuously as the mixture begins to thicken and turn creamy, about 2–3 minutes. Look for a rich, slightly glossy sauce that coats the sausage and peppers evenly.
Add the cooked pasta to the skillet along with the shredded cheese. Toss everything together over low heat until the cheese melts and the sauce becomes smooth and luscious, coating each piece of pasta and filling the skillet with a creamy texture. Adjust seasoning with salt and pepper as needed.
Serve immediately, garnished with additional cheese or herbs if desired, showcasing a juicy, flavorful dish with a creamy coating and visible chunks of sausage and peppers.
