Cook the Pasta: Boil a pot of salted water and cook the pasta until al dente, according to package instructions. Drain and set aside, reserving a cup of pasta water for later.

Cook the Sausage: While the pasta cooks, heat 1 tablespoon of olive oil in a large skillet over medium heat. Add the sausage, breaking it up into small pieces, and cook until browned and fully cooked. Remove the sausage from the skillet and set aside.

Sauté the Mushrooms: In the same skillet, add the remaining olive oil. Add the sliced mushrooms and cook for about 5 minutes until they start to brown. Add a pinch of salt to help the mushrooms release their moisture.

Add Garlic and Balsamic Vinegar: Add minced garlic to the mushrooms, stirring until fragrant, about 1 minute. Pour in the balsamic vinegar, letting it reduce slightly and coat the mushrooms, creating a tangy glaze.

Combine Ingredients: Return the cooked sausage to the skillet, stirring to mix. Add the cooked pasta to the skillet, along with a splash of reserved pasta water to help the sauce coat the pasta. For a creamier sauce, add the heavy cream at this stage and stir well.

Finish with Parmesan: Stir in grated Parmesan, allowing it to melt and blend into the pasta. Season with salt and pepper to taste.

Garnish and Serve: Garnish with fresh parsley, and serve warm. For extra flavor, add a drizzle of balsamic glaze or additional Parmesan on top.