Preheat oven 350 degrees.
Cut tops off bell peppers and set aside. Remove seeds and membranes and discard. Using a paring knife, cut Jack O’ Lantern faces into each pepper.
Heat butter in a large skillet over medium heat. Sauté onion and garlic until softened. Add Italian sausage and cook until browned. Drain and discard any grease.
Stir in tomatoes, rice, water, and rice. Cover skillet and simmer until rice is tender, approximately 15 minutes. Remove from heat and stir in shredded cheese.
Stuff each pepper with rice and sausage mixture, and replace pepper tops. Arrange peppers, top-side up, in a baking dish and cover with foil.
Bake in the preheated oven 30 to 35 minutes or until heated through and cheese is melted.