Prepare ingredients: mince garlic, dice onion, and crush tomatoes if using whole.
Cook pasta in salted water until just shy of al dente. Reserve 1 cup pasta water before draining.
Heat olive oil in a large skillet over medium heat. Cook diced onions until translucent (3-4 minutes).
Add garlic and cook until fragrant (30-60 seconds).
Add tomato paste and cook for 1-2 minutes, then add crushed tomatoes, herbs, and red pepper flakes.
Simmer sauce for 10-12 minutes until slightly reduced.
Reduce heat to medium-low and slowly pour in cream while stirring. Simmer 3-4 minutes until slightly thickened.
Add drained pasta to sauce and toss to combine. Cook 1-2 minutes more.
Remove from heat, stir in Parmesan cheese, and season with salt and pepper to taste.
Serve with additional Parmesan and fresh basil.