Brown the sausage: In a large soup pot or Dutch oven over medium heat, cook Italian sausage until browned and cooked through. Drain excess grease if needed.

Build the flavor base: Add diced onion and sauté 3–4 minutes until softened. Stir in garlic and cook for 30 seconds until fragrant.

Simmer the soup: Pour in chicken broth and diced tomatoes. Add Italian seasoning, salt, and pepper. Bring to a gentle boil.

Add pasta: Stir in ditalini and cook uncovered for 8–10 minutes, until just al dente.

Make it creamy: Reduce heat to low. Slowly stir in the heavy cream. Gradually add parmesan, stirring until melted and smooth.

Add greens: Stir in spinach until wilted, about 1–2 minutes. Adjust seasoning.

Serve hot: Ladle into bowls and garnish with extra parmesan and a pinch of red pepper flakes if desired.