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

Next, add the chopped onion to the pot, cooking for an additional 5 minutes until soft and translucent. Stir in minced garlic and crushed red pepper flakes, cooking for 30 seconds until fragrant.

Add uncooked orzo to the pot along with chicken broth and heavy cream. Increase heat to bring to a boil, stirring gently to combine.

Once boiling, reduce heat to a gentle simmer and cook uncovered for about 10 minutes, stirring frequently to prevent sticking.

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

Finally, season with salt and pepper to your liking. Serve immediately in bowls.