In a large sauté pan, heat the olive oil over medium-high heat.

Add the ground sausage to the hot pan. Cook for 8-10 minutes until browned.

While the sausage cooks, bring a large pot of water to a boil for the pasta.

Line a bowl with a paper towel. Once the sausage has cooked, remove the sausage from the pan and place in the bowl. The paper towel helps drain the excess oil from the sausage.

Add the onions, black pepper, red pepper flakes and salt to the pan. Sauté for 3 minutes or until the onions are translucent.

Cook the orecchiette to al dente according to package directions. Reserve ⅓ cup of the starchy pasta water from the pot. Once cooked, drain the orecchiette well and set aside.

Once the onions are translucent, add the garlic to the pan and cook for an additional 3 minutes.

Once the garlic has cooked, add the bell peppers to the pan and cook for 3 minutes or until the bell peppers begin to soften.

Turn the heat to low and add the cooked sausage back to the pan with the vegetables. Add the butter, stir, and remove the pan from heat.

Add the orecchiette and reserved pasta water to the sausage and pepper mixture. Stir together for 2-3 minutes or until the pasta is evenly coated.

Add the Parmesan and stir together to combine.