Add sausage to skillet, breaking it up with a fork or hamburger masher. Brown the sausage meat over medium heat until it is no longer pink.
Sprinkle 1/3 cup of all-purpose flour evenly over the top of browned sausage. Stir to mix flour and sausage together. Cook for 1 minute.
Slowly add milk, a little at a time, stirring constantly. Add Worcestershire sauce, and continue stirring until sausage gravy is thick and creamy. If milk gravy gets too thick, add up to 1/2 cup of milk a little at a time. Salt and pepper to taste.
Pour gravy into a serving dish, and serve over hot biscuits, bread, rice, or pasta. Spoon on a generous helping of sausage gravy so that the biscuit, bread, rice, or pasta is evenly covered. Serve warm.
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Notes
Substitutions:Turkey Sausage Gravy - Substitute ground turkey or turkey sausage for the pork sausage. Add 1 teaspoon of fennel seed and 1 teaspoon of sage to give it that traditional sausage taste.Hamburger Gravy - Substitute ground beef for the pork sausage. Add 1 tsp fennel seed and 1 teaspoon of sage, and a little beef bouillon for flavor.Storing leftovers: The gravy should be cooled first before storing, then transferred to a sealed container, and kept in the fridge for 3-4 days. Reheat the gravy on the stovetop, and add a splash of milk if needed to thin it out a bit.