In a heavy soup pot or Dutch oven, heat the pan over medium-high heat and add crumbled Italian sausage. Cook for about 5 minutes, stirring occasionally, until the sausage is browned and cooked through.

Stir in the chopped onion and allow it to cook for an additional 5 minutes until softened and translucent.

Add the minced garlic and red pepper flakes. Cook for about 30 seconds, allowing the garlic to become fragrant.

Fold in the uncooked orzo pasta, then pour in the chicken broth and heavy cream. Bring to a gentle boil over medium heat.

Reduce heat to medium-low and simmer uncovered for about 10 minutes, stirring frequently until the orzo is tender.

Remove from heat and mix in the freshly grated Parmesan cheese and packed baby spinach. Cover for 3-5 minutes to wilt spinach.

Adjust seasoning with salt and pepper to taste. Serve warm.