Heat a large skillet over medium-high heat. Cook and stir sausage in the hot skillet until browned and crumbly, 5 to 7 minutes; drain and discard grease, reserving about 2 tablespoons in the skillet. Reduce heat to medium-low.
Stir flour, beef bouillon, and black pepper into sausage until evenly coated and grease is absorbed, 2 to 3 minutes. Gradually stir milk into sausage mixture; add Worcestershire sauce. Simmer gravy, stirring often, until thickened, 10 to 15 minutes.
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