Gather all ingredients.

Heat oil from sun-dried tomatoes in a large pot over medium-high until shimmering. Add sausage; cook, stirring occasionally, until sausage crumbles and is almost fully cooked through, about 5 minutes. Add onions and garlic; cook, stirring occasionally, until softened, about 5 minutes.

Add tomato paste and sun-dried tomatoes; cook, stirring constantly, until tomato paste is slightly deeper red in color and fragrant, about 2 minutes.

Stir in broth, cream, basil, salt, Italian seasoning, and paprika; bring to a boil over medium, stirring occasionally, until bubbling and frothy on top, about 12 minutes. Add pasta and reduce heat to medium-low; cook, uncovered, stirring occasionally, until orzo is al dente, about 8 minutes.

Reduce heat to low, and add spinach, cream cheese, and Parmesan; cook, stirring often, until cream cheese and spinach is wilted, about 5 minutes.

Garnish with additional Parmesan cheese and basil before serving.