In a large skillet, cook the sausage over medium-high heat until browned and crumbly. Drain the grease and set aside.
While the sausage cooks, prepare your smoker following the manufacturer's instructions for a steady 220 °F (104 °C) temperature.
Remove the silver skin and fat from the pork loin. Slit the loin lengthwise but not all the way through, then unfold it flat. Season both sides with a pork rub. Layer on the cream cheese, jalapeños, pimientos, and cooked sausage. Carefully roll up the loin into a tight log and secure with cooking twine.
Place the rolled pork loin in the preheated smoker. Smoke until an instant-read thermometer inserted into the center reads 140-145 °F (60-63 °C), approximately 2 hours. Remove the loin, wrap in foil, and let it rest for at least 20 minutes before serving.
For a smoky flavor, add a few wood chips to your smoker or grill.
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