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1
Bring a large pot of water to a boil over high heat.
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2
Set a medium saute pan with high sides over medium-high heat and add half of the butter.
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3
When the butter is foamy and turns a light golden brown, add the sausage and cook until its well browned, breaking it up with a wooden spoon as it cooks, about 4 to 5 minutes.
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4
Add the sage, stir to combine, remove the pan from the heat, and set aside.
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5
Add the orecchiette and a generous pinch of salt to the boiling water.
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6
Cook until the pasta is al dente, stirring frequently, about 8 minutes, depending on the brand of pasta (check the cooking recommendations on the package).
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7
Use a ladle to reserve 1 cup of the pasta cooking water, then drain the orecchiette.
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8
Set the pan with the browned sausage over medium heat and add the pasta.
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9
Stir to combine, scraping up any browned bits stuck to the bottom of the pan.
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10
Add the reserved pasta water 1 tablespoon at a time, stirring until a sauce begins to form.
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11
Reserve 1 tablespoon of the pecorino cheese and add the rest to the pasta.
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12
Add the remaining butter and stir to combine.
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13
Keep adding more of the reserved pasta water as needed until the sauce emulsifies into a creamy sauce that clings to the pasta.
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14
Season with black pepper and taste, adding additional salt if needed.
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15
Divide the pasta evenly between 2 warmed plates.
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16
Garnish with the reserved pecorino and serve.
