Step 1: Heat a few tablespoons of oil or butter in large skillet over medium-high heat. Add sausage meat, onion and garlic; cook until browned, stirring occasionally. Drain.
Step 2: Add tomato sauce, dry pasta shells and water; stir to combine. Bring to a boil. Add salt and pepper. Cover; reduce heat and cook 12-15 minutes or until pasta is tender.
Step 3: Stir in ketchup (add in more that 1/3 cup if you like) heat through.
Step 4: Top with cheese and let stand until cheese melts.
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