Bring a large pot of salted water to a boil and cook pasta until al dente, about 9-11 minutes. Reserve 1 cup of pasta water, then drain.

In a skillet over medium heat, add olive oil and cook the sausage, breaking it into small pieces with a spatula, about 7 minutes.

Add garlic and more olive oil if needed. Pour in white wine and scrape up any browned bits from the skillet bottom.

Simmer until the wine is reduced by half, then add pasta water and half the Parmesan cheese. Stir to combine.

Add heavy cream and season with salt and pepper. Cook for 1 minute, then stir in the pasta.