Heat olive oil in a large saucepan over medium heat.
Add the onion and pancetta and cook for about 4 minutes, or until the pancetta is crispy.
Add the garlic to the pan and cook for 1-2 minutes or until the garlic is fragrant.
Stir in the tomatoes, pumpkin puree, and vodka and bring the sauce to a simmer. Cook for 30 minutes.
Reduce heat to low and gradually stir in heavy cream and Parmesan cheese. Season with salt and pepper and continue to cook until sauce is creamy.
While the sauce is cooking prepare your pasta according to package.
Once the pasta is cooked, add the pasta (plus a little pasta water) to the sauce and stir to incorporate.
Serve with red pepper flakes, extra Parmesan cheese, and fresh basil leaves on top, if desired.