Gather your ingredients and cook your sausage. Remove sausage from skins and brown in a large skillet or shallow Dutch Oven. I like to use a mild Italian sausage for this recipe.
Prepare the Vegetables
While the sausage is cooking, prepare the vegetables. Chop the onion, bell pepper, zucchini, and yellow squash.
Slice the mushrooms. Mince the garlic. Chop the Fresh Herbs.
Make the Sauce
Once the sausage is fully browned, add in the chopped vegetables and garlic. Cook on medium low until tender, 10-12 minutes. Add 1-2 tablespoons olive oil, if needed.
Place whole tomatoes in a medium bowl. Crush by hand. Add tomatoes and juices to the vegetables. Stir to combine. Pour red wine and wine vinegar over the vegetables.You may use canned crushed tomatoes if desired, but hand crushed is better.
Season with fresh parsley and basil. If using dried herbs, use 1 tablespoon dried parsley and 2 teaspoons dried basil.
Next, sprinkle in the red pepper flakes, and then finish off with kosher salt and freshly ground black pepper. Continue to cook on low for another 10-12 minutes until the sauce has reduced and is slightly thickened.
Prepare the Pasta
While the sauce simmers, prepare the pasta according to package directions. Cook to al dente.
Using pasta tongs, transfer the pasta into the vegetable sauce and carefully stir to combine. You may use extra pasta water if the sauce needs more liquid.