Bring a large pot of salted water to a rolling boil. Add 12 oz of penne pasta and cook until just al dente, about 8-10 minutes. Reserve ½ cup of pasta water, drain the rest, and set aside.

In a large skillet, heat 1 tablespoon of olive oil over medium heat. Add 1 lb of sweet Italian sausage, breaking it apart. Cook for about 5-7 minutes until browned.

Add 3 minced garlic cloves to the skillet and sauté for 1 minute. Stir in 1 cup of canned pumpkin purée, ½ cup of chicken broth, and ½ cup of heavy cream. Add ¼ teaspoon of ground nutmeg, along with salt and pepper, and let simmer for 5-7 minutes.

Add the cooked pasta to the pumpkin and sausage mixture. Toss gently until the pasta is evenly coated. Stir in ½ cup of grated Parmesan cheese.

Serve hot, garnished with chopped parsley and red pepper flakes if desired.