Bring a pot of water to boil. Once boiling, add pasta and cook according to package directions. When pasta is cooked al dente or to your liking, drain well, but do not rinse.
8 ounces orecchiette pasta
Meanwhile, in a large skillet over medium-high heat, cook Italian sausage.
1 pound Italian sausage
When the sausage is about halfway cooked, add the onions. Continue cooking until the sausage is cooked through.
½ cup diced onion
Drain off any excess grease.
Add garlic and seasonings and stir together.
1 teaspoon garlic, ¼ teaspoon Italian seasoning, ¼ teaspoon red pepper flakes
Add chicken broth and stir to deglaze the pan scraping up any browned bits stuck to the pan. Cook for 1-2 minutes until about half of the liquid has evaporated.
½ cup chicken broth
Stir in heavy cream and then stir in spinach. Cook for 2-3 minutes until the cream begins to thicken and the spinach wilts.
1 cup heavy whipping cream, 2 - 4 cups fresh spinach
Stir in cooked and drained pasta.
Stir in freshly grated Parmesan and lemon zest.
¼ cup freshly grated Parmesan cheese, ½ lemon zest
Taste and add salt and pepper if needed. Garnish with freshly chopped parsley if desired.
If sauce is too thick, add a bit of saved pasta water and stir until desired consistency. Add just a few tablespoons at a time. You can also use chicken broth.
½ cup pasta water
Notes
Start the pasta water right away. As soon as it's boiling, add the pasta and then start cooking the rest of the ingredients. The pasta should be finished about the same time as you are ready to add it to the sauce. This may vary depending on the type of pasta you are using.
Before draining the pasta, scoop out a cup of the pasta water. You might need to use a bit if the sauce is too thick. Pasta water is perfect for adding to the sauce because it has starch from the pasta and helps make the sauce extra silky.
Make certain the pasta is fully drained. I give the colander a couple of shakes to help remove water that's stuck in the bowl part of the pasta.
Taste the sauce before adding any salt or pepper. Many of the ingredients already contain salt and you may not need to add any.
Feel free to double the amount of spinach. It seems like a lot, but it cooks way down.