Everyone has had spaghetti and meatballs, but not quite like this! Plump, flavorful and spicy andouille sausage meatballs are simmered in tomato basil sauce, then served over pasta for the ultimate classic meal with a twist. Between the hearty, Cajun-inspired meatballs and the herbaceous, decadent sauce, there’s just no way to lose with this recipe.
Add the Italian sausage, andouille sausage, breadcrumbs, Worcestershire sauce, Italian seasoning and egg to a medium bowl and mix together using your hands until well combined. Form the mixture into small to medium meatballs (about 1 1/2 tablespoons each; 16 total meatballs) and set aside on a parchment-lined baking sheet.
Add the olive oil to a large pan or cast-iron skillet over medium-high heat. Cook the meatballs in batches, turning them over on all sides to make sure they are browned but not completely cooked through, until golden brown, 7 to 8 minutes. Add more olive oil if needed to cook all the meatballs.
As the meatballs cook, boil the spaghetti according to the package instructions. Reserve 1/2 cup of the pasta water, then drain.
Once the meatballs are browned, add them all back to the pan and pour in the pasta sauce. Add the reserved pasta water, then cover, bring to a simmer and cook until the meatballs are cooked through, about 10 minutes.
Either toss the cooked spaghetti into the sauce or spoon the sauce and meatballs over the cooked spaghetti. Garnish with Parmesan and parsley if desired and serve.