1) Break up and fry the best sausage you can justify buying and putting in a cocktail. Avoid sausages with sawdust and flour as components. That's a rule for life, not part of the recipe.
2) Start with rum; add some. This is the booze. I use Bacardi because it's around. Dark rum might work well, but I've never tried it.
3) Add a bit of Cointreau or triple sec or some orange-based liqueur.
4) Top it up with tomato juice.
[Edit: 4a) I may also put a dash of hot sauce of some variety in there... I can't remember. I might just be getting crossover from Bloody Marys]
5) Drop a chunk of sausage into the glass and stick another chunk on the rim. Fucking garnish, yo.
6) Insert in face hole.
I really should have an evening where I just experiment with these and Marmitinis to really nail down the perfect mix.