Brown the sausage in a skillet, breaking into pieces as it cooks. Transfer to a large bowl.
To the bowl, add pumpkin, onion, garlic, tomato sauce, diced tomatoes, balsamic vinegar, oregano, salt, thyme, basil, red pepper flakes, and water. Stir to combine, then add pasta and stir again.
Transfer mixture to a 9 x 13 baking dish and bake for one hour until pasta is tender. During the last 15 minutes of cooking time, add mozzarella cheese and return to the oven.
Let cool for 5-10 minutes before serving.
Enjoy!
Recipe by For the Love of Gourmet at https://fortheloveofgourmet.com/no-boil-pumpkin-ziti/