How to Cook Fresh Sausage. Make sausage patties out of the fresh sausage. If the sausage contains a lot of fat, you may want to make patties slightly larger to allow for shrinkage during cooking. Add 1 tbsp. olive oil to frying pan, 1/2 cup water, and place on burner over medium low heat. Place sausage patties in the frying pan and cook over medium heat for 2 or 3 minutes, depending on thickness. Using a spatula, turn sausage patties over and allow to cook an additional 2 to 3 minutes. Remove from heat and place on paper towels to drain.