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

Add chopped onion to the pot and cook for another 5 minutes, stirring frequently until the onion is softened and translucent.

Stir in minced garlic and a pinch of crushed red pepper flakes, sauté for about 30 seconds.

Add uncooked orzo to the pot, stirring well to combine all ingredients evenly.

Pour in the chicken broth and heavy cream, stirring to combine, and bring to a boil.

Reduce the heat to low and simmer uncovered for about 10 minutes, stirring frequently.

Once the orzo is tender, remove from heat and mix in freshly grated Parmesan and baby spinach. Cover for 3-5 minutes until spinach wilts.

Season to taste with salt and pepper, stirring gently to ensure everything is well combined.