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March 31, 2026

Mrs. Watson’s Wiggle

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Mrs. Watson’s Wiggle–a comforting Instant Pot pasta loaded with Italian sausage, tomatoes, spinach, and melty cheddar cheese for an easy weeknight dinner.

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Cheesy Sausage Tomato Macaroni (Instant Pot)

Mrs. Watson’s Wiggle

This recipe is a yummy slurp slurp type of weeknight meal. The Italian sausage is a W because it flavors the whole dish. If you want to make it even better, use a good-quality Italian sausage and don’t skip that little splash of balsamic at the end…it really wakes everything up. (This recipe comes from Just a Pinch. I have no idea where the title comes from, but I think it’s fun!)

Ingredients/Substitution Ideas

  • Ground Italian sausage–I used mild
  • Dried onion flakes–or 1 cup diced fresh onion
  • Garlic powder–or 1 Tbsp minced garlic
  • Chicken broth–or water and Better than Bouillon chicken base
  • Elbow macaroni–or any short pasta like shells or rotini
  • Crushed tomatoes
  • Spinach–or kale
  • Half and half–or heavy cream or whole milk
  • Shredded cheddar cheese–or mozzarella or Italian blend
  • Balsamic vinegar
  • Salt–to taste

Steps

Turn Instant Pot to sauté setting. When display says HOT add in the sausage and break it up. Add in the onion. Brown for about 5 minutes. If there is excess grease drain it off. 

Stir in the garlic powder. Pour in the broth and scrape bottom of pot so that nothing is sticking. Turn off Instant Pot. 

Sprinkle in the macaroni evenly. Dump the tomatoes on top. 

Cover Instant Pot and secure the lid. Make sure valve is set to sealing. Set manual/pressure cook button to 4 minutes. When time is up let pot sit for 5 minutes and then move valve to venting. Remove the lid. 

Temper the half and half and stir it in.

Stir in the spinach, cheddar and balsamic. Taste test and add salt, if needed.

Serve and enjoy!

Cheesy Sausage Tomato Macaroni (Instant Pot)

Notes/Tips

  • Serve with garlic toast and a green salad.
  • Want more veggies? Stir in mushrooms or bell peppers with the sausage.
  • Make sure you don’t stir after adding the tomatoes to prevent the burn notice.
  • Warm the half and half before adding so it blends smoothly into the hot pasta.
  • I used my 4 quart Instant Pot*. You can also make this in a 6 or 8 quart pot.
  • Store leftovers in an airtight container* in the refrigerator for up to 4 days. You can freeze it, but the texture of the pasta may soften a bit after thawing.
  • Other recipes you can make with balsamic are Instant Pot Flank Steak and Instant Pot Chicken Margherita Pasta.
Did you know you can filter the recipes on my website to search by meat type, IP or Crockpot, low carb, gluten free, etc.? Use the filter to find exactly what you are looking for. 

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Cheesy Sausage Tomato Macaroni (Instant Pot)
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Mrs. Watson’s Wiggle


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  • Author: 365 Days of Slow and Pressure Cooking
  • Prep Time: 20 minutes
  • Cook Time: 4 minutes (plus 5-10 minute NPR)
  • Total Time: 24 minutes
  • Yield: 6 servings 1x
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Description

A comforting Instant Pot pasta loaded with Italian sausage, tomatoes, spinach, and melty cheddar cheese for an easy weeknight dinner.


Ingredients

Scale
  • 16 oz ground Italian sausage
  • 2 Tbsp dried onion flakes or 1 cup diced onion
  • 1 tsp garlic powder
  • 2 cups chicken broth
  • 8 oz elbow macaroni
  • 28 oz crushed tomatoes
  • 1 cup chopped spinach
  • 3/4 cup half and half, warmed
  • 1 cup shredded cheddar cheese
  • 1 Tbsp balsamic vinegar
  • Salt, to taste

Instructions

  1. Turn Instant Pot to sauté setting. When display says HOT add in the sausage and break it up. Add in the onion. Brown for about 5 minutes. If there is excess grease drain it off. 
  2. Stir in the garlic powder. Pour in the broth and scrape bottom of pot so that nothing is sticking. Turn off Instant Pot. 
  3. Sprinkle in the macaroni evenly. Dump the tomatoes on top. 
  4. Cover Instant Pot and secure the lid. Make sure valve is set to sealing. Set manual/pressure cook button to 4 minutes. When time is up let pot sit for 5 minutes and then move valve to venting. Remove the lid. 
  5. Stir a cup of the hot mixture into the half and half to temper it. Stir in the spinach, half and half, cheddar and balsamic. Taste test and add salt, if needed.
  6. Serve and enjoy!
  • Category: Pasta, Sausage
  • Method: Instant Pot

Pin this recipe for later!

Cheesy Sausage Tomato Macaroni (Instant Pot)

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*Karen Petersen is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.

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Hi, I’m Karen. I know that dinner time can be less than relaxing. Busy schedules and cranky kids and a hundred other things can lead to weariness when it comes to putting dinner on the table. I can help! I make homemade, family-friendly slow cooker and Instant Pot dinners and share the recipes with you.

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