
The vodka sauce you know and love just got a sweet fall twist in this creamy pumpkin vodka sauce and penne recipe.
Bring a large pot of salted water to a boil. Add pasta and cook, stirring occasionally, until al dente according to package instructions. Reserve 1 cup pasta water before draining.
Meanwhile, in a large straight-sided skillet over medium heat, heat oil. Add sage and cook, stirring frequently, until crisp, about 1 minute. Using tongs, transfer sage to a paper-towel lined plate, leaving any excess oil in skillet.
In same skillet over medium heat, melt butter. Cook onion, garlic, and red pepper flakes, stirring occasionally, until vegetables are softened but not golden, 6 to 8 minutes. Add tomato paste and cook, stirring constantly, until slightly darkened in color and toasted, about 2 minutes.
Pour in vodka and bring to a boil. Cook, stirring occasionally, until vodka is reduced by about three-quarters, about 2 minutes. Stir in pumpkin puree, Parmesan, water, cream, nutmeg, and 3/4 teaspoon salt until cheese is melted and mixture is smooth and combined.
When pasta is ready, return skillet to medium-high heat. Add 1/2 cup pasta water, stir to combine, and bring to a boil. Add pasta and stir until pasta is well coated with sauce, adding more pasta water 1 tablespoon at a time if necessary to thin sauce; season with salt and red pepper flakes.
Spoon pasta onto plates. Top with crispy sage, more Parmesan, and a drizzle of oil.