Bring a large pot of salted water to a boil. Add the spaghetti and cook according to package instructions until al dente.

Drain the pasta and reserve about 1 cup of pasta water.

In a large skillet, heat olive oil over medium heat. Add the sausage and cook until browned, breaking it up with a wooden spoon, about 5-7 minutes.

Add minced garlic and cook for another minute until fragrant.

Pour in the chicken broth, lemon zest, and lemon juice. Bring to a simmer and let it reduce for about 5 minutes.

Stir in the heavy cream and parmesan cheese, mixing until well combined. Season with salt and pepper.

Add the cooked pasta to the skillet with the sauce, tossing to coat. If the sauce is too thick, add reserved pasta water a little at a time until desired consistency is reached.

Serve immediately, garnished with fresh parsley and additional parmesan if desired.