Inspired by my Italian mother-in-law Gerri, this homemade spaghetti sauce features tender beef meatballs simmered in a rich tomato sauce with garlic, basil, oregano, and Italian herbs. Slowly cooked to develop wonderful flavor, it's a comforting family dinner served over your choice of pasta.
In a large mixing bowl, combine the ground beef, Parmesan cheese, breadcrumbs, milk, parsley, oregano, basil, garlic powder, egg, salt, and pepper.
Add more water, if needed, to ensure that the meatballs and sausage are submerged in the sauce.
Gently mix the ingredients together using your hands until evenly combined. Avoid overworking the meat.
Roll the mixture into approximately 1½-inch meatballs and set aside while preparing the sauce.
Spaghetti Sauce
Combine the tomato sauce, tomato paste, water, garlic, oregano, basil, parsley, onion powder, Italian seasoning, black pepper, and salt in a large stockpot. Stir until thoroughly combined.
Bring the sauce to a gentle simmer over medium heat, stirring occasionally to prevent sticking.
Carefully add the uncooked meatballs one at a time, distributing them evenly throughout the sauce. Add the optional Italian sausage.
Reduce the heat to low, partially cover the pot, and simmer gently for approximately 2 to 4 hours, stirring occasionally. Avoid vigorous stirring until the meatballs have firmed up.
Check that the meatballs and sausage are fully cooked. Ground beef meatballs and pork Italian sausage should reach an internal temperature of 160°F.
Taste the sauce and adjust the seasonings as desired. If the sauce becomes too thick, stir in a small amount of water.
Cook your preferred pasta according to the package directions. Drain and toss with a little of the prepared sauce.
Serve the pasta topped with additional spaghetti sauce and meatballs.
Garnish with freshly grated Parmesan cheese, if desired.