I used to think making homemade cream sauce was a complicated + involved process. I also thought it was too high calorie of a food for me to eat at home— cream sauce was reserved for special occasions at a restaurant. But THEN, I tried making it myself and realized, A) it is very, very simple, and B) I absolutely love cream sauce, so I’d like to eat it more than once a year. Pesto and brussels sprouts are also some of my fav things, so I decided to toss ’em all together to create a perfect, simple weeknight meal: brussels sprouts pasta with pesto cream sauce.

If you’re not as obsessed with brussels sprouts as I am, you could easily substitute broccoli. And if you want to add a protein to this dish, we have added ground Italian sausage and ground turkey before— both are delish.

The ingredients—
Pasta: Medium shells are WHERE. IT’S. AT. We’ve tried penne, fusilli, small shells, rigatone. I can’t explain it, but the medium shells (also known as conchiegle — here is the kind we get) simply is the best type of pasta for this dish. My husband agrees, and usually he could care less about shapes of things as long as they taste the same lol. But I’m TELLING YOU, he actually thinks medium shells are necessary here.
Brussels sprouts: I like to quarter them for this recipe, instead of halve them. When you’re cooking all the veggies together, you’ll know they are done when you can pierce a brussels sprout with a fork, yet there is still some crisp to it (don’t let them get too soft!).
Mushrooms + onions: Dice these up about the same size. No larger than a centimeter.
Garlic: LOTS OF FRESH GARLIC. This adds so much flavor to the dish. Garlic powder will not do the trick here. Ya need the fresh stuff.
Heavy cream: When you start making the cream sauce, you should be almost constantly gently stirring the cream with a whisk. Also, don’t let it boil. If you follow these two rules, you can’t mess it up 🙂 (Side note: heavy whipping cream also works just fine.)
Parmesan cheese: Freshly grated is the way to go. It truly makes a difference.
Pesto: If you are going all out and want to make this homemade, GO FOR IT. Next summer, I plan to grow my own basil and you bet I’ll be making my own pesto then. But for now, the jar saves me time and it still makes an absolutely delicious pesto cream sauce. Do what works for your lifestyle.

Alright, let’s dive into the recipe! Let me know in the comments if you are as obsessed with how the cream sauce turns out as we are. Oh, and if you like brussels sprouts + Italian-inspired food, you may also like my easy brussels sprouts pizza recipe!
Brussels Sprouts Pasta with Pesto Cream Sauce
Serving Size: 4
Cooking Time: 30 minutes
INGREDIENTS:
- 1-2 tablespoons olive oil
- 4 servings pasta (~2 cups dry pasta)
- 2 cups brussels sprouts (10-20 brussels sprouts depending on the size), quartered
- ¾ cup mushrooms, diced
- 1 small yellow onion, diced
- 6 cloves garlic, minced, divided
- 1/2 teaspoon black pepper
- 1/4 teaspoon salt
- 1 cup heavy cream
- 2 tablespoons butter
- 1 tablespoon flour
- 1/2 cup parmesan cheese, freshly grated
- 1/4 cup jarred pesto
DIRECTIONS:
- Begin heating water for pasta while chopping veggies and grating parmesan cheese.
- In a large skillet, heat olive oil. Once hot, add brussels sprouts, mushrooms, 4 cloves garlic, and onion, and cook over medium heat for about 8-10 minutes or until brussels sprouts are tender-crisp. Season with salt and pepper.
- When water for pasta is boiling, begin cooking pasta according to package instructions.
- In a separate small saucepan, melt butter and 2 cloves garlic over medium heat. Whisk in flour until smooth.
- Slowly add cream, whisking frequently for 4-5 minutes, careful not to let it boil. Remove from heat and whisk in grated parmesan cheese until melted and smooth.
- Mix together pasta and cream sauce. Stir in pesto + brussels sprouts mixture. Enjoy!

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