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Cook the Sausage: Heat the olive oil in a large skillet over medium-high heat. Add the Italian sausage, breaking it up with a spoon into bite-sized pieces. Cook until browned and no longer pink, about 5-7 minutes. Use a slotted spoon to transfer the cooked sausage to a plate, leaving the drippings in the skillet.
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Sauté Aromatics: Reduce the heat to medium. Add the diced onion to the skillet and cook until softened and translucent, about 3-4 minutes. Add the minced garlic and cook for another 30 seconds until fragrant.
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Simmer Tortellini: Pour in the chicken stock, increase the heat to high, and bring to a low boil. Add the frozen tortellini directly to the skillet. Cook according to package directions (typically 3-4 minutes for frozen), stirring occasionally. The tortellini will absorb some of the stock as it cooks.
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Create Creamy Sauce: Reduce the heat to medium-low. Pour in the heavy cream and stir to combine. Let the mixture simmer gently for 1-2 minutes.
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Finish the Dish: Add the cooked sausage, fresh spinach, and grated Parmesan cheese to the skillet. Stir continuously until the spinach has wilted and the cheese has melted into a smooth, creamy sauce, about 2-3 minutes. The sauce will continue to thicken as it stands.
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Season and Serve: Season with red pepper flakes, salt, and pepper to taste. Serve immediately, garnished with extra Parmesan cheese if desired.
Chef’s Notes
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Fresh vs. Frozen Tortellini: You can use fresh refrigerated tortellini instead of frozen. The cook time will be slightly shorter, so check the package directions and reduce the simmering time accordingly.
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Vegetable Boost: Feel free to add other vegetables like sliced mushrooms or sun-dried tomatoes along with the onions.
