Bring a large pot of salted water to a boil. Add the rigatoni and cook according to the package instructions until al dente, about 9-11 minutes.
Reserve about 1/2 cup of pasta water before draining the pasta. Set the pasta aside.
Making the Spicy Sauce
In a large skillet, heat the olive oil over medium heat.
Add the garlic and onion, sautéing for 3-4 minutes, until softened and fragrant.
Stir in the tomato paste and cook for 2-3 minutes until it darkens slightly.
Add the crushed tomatoes and red pepper flakes, stirring to combine. Let the sauce simmer for 10 minutes, allowing the flavors to meld.
If you’re using vodka, pour it in at this stage and let it cook down for about 2 minutes.
Lower the heat and add the heavy cream. Stir well, creating a rich, creamy sauce. Season with salt and black pepper to taste.
Combining and Serving
Add the drained rigatoni to the skillet with the sauce, tossing to coat the pasta evenly. If the sauce is too thick, add some reserved pasta water to loosen it up.
Once the pasta is well coated, stir in the Parmesan cheese, allowing it to melt into the sauce.
Serve the pasta in bowls, garnished with fresh basil leaves and an extra sprinkle of Parmesan if desired.