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meatballs and pasta in creamy red pepper pesto sauce in a bowl

Creamy Pesto Pasta with Meatballs

This Creamy Pesto Pasta is made with fire roasted red peppers, fresh basil, garlic, tomatoes and cream and served with the most amazing spicy Sicilian style meatballs - plus, its ready in under 30 minutes!!
Course Main Course
Cuisine Italian
Prep Time 10 minutes
Cook Time 20 minutes
Total Time 30 minutes
Servings 6 servings
Calories 455kcal


  • 1 package Carando Fresh Italian-Style Sicilian Meatballs - 12 count
  • 8 oz. spaghetti
  • 1 tbsp. olive oil
  • 3 garlic cloves minced
  • 2 tomatoes chopped
  • cup red wine
  • cup heavy cream

Red Pepper Pesto:

  • 12 oz. jar roasted red peppers
  • ¼ cup pine nuts
  • cup olive oil
  • ½ cup basil packed
  • 1 tsp. red chili flakes
  • ½ tsp. salt
  • ¼ tsp. black pepper
  • ½ tsp. coconut sugar
  • ¼ cup shredded Parmesan cheese


  • Cook the spaghetti for about 8 minutes and drain. Pasta will not be fully cooked - it will finish cooking in the sauce.
  • Cook the meatballs according to the package instructions (or bake meatballs for 10 minutes per side). Then place them in a skillet to brown them after baking - I like a nice crust on my meatballs. Set aside.
  • Heat the olive oil in a large skillet over medium heat. Add the garlic and saute until it starts to brown, about 2-3 minutes.
  • Add the fresh chopped tomatoes and cook for 2 minutes.
  • Add the pesto sauce (below) and red wine and bring to a simmer.
  • Add the cream, bring to a simmer, reduce heat and simmer for about 5-7 minutes, until sauce has reduced and thickened slightly.
  • Add the pasta to the sauce and let cook for about 2 minutes.
  • Add the meatballs, mix to coat with the sauce and serve sprinkled with additional Parmesan cheese and fresh basil (optional).

Red Pepper Pesto:

  • Toast the pine nuts in a skillet over medium low heat until lightly browned.
  • Combine all the ingredients in a blend and pulse until fully combined.


  1. Any kind of pasta can be used in place of the spaghetti;
  2. Add more crushed red pepper for added spice if desired;
  3. This can also be made with basil pesto - try this Basil Pesto recipe from the Suburban Soapbox.
  4. Add sauteed broccoli, spinach, peas, red peppers or any vegetable to make this a complete one-pot meal.


Serving: 1cup | Calories: 455kcal | Carbohydrates: 35g | Protein: 9g | Fat: 31g | Saturated Fat: 9g | Cholesterol: 41mg | Sodium: 1033mg | Potassium: 369mg | Fiber: 3g | Sugar: 3g | Vitamin A: 1407IU | Vitamin C: 33mg | Calcium: 111mg | Iron: 2mg