Brown the Italian sausage: In a large pot or Dutch oven over medium heat, add the Italian sausage. Cook, breaking it apart with a spoon, until it’s browned and cooked through (about 5-7 minutes). Drain excess fat if necessary.

Sauté the vegetables: Add the chopped onion, bell pepper, and minced garlic to the pot with the sausage. Sauté for about 3-4 minutes until the onions are translucent and fragrant.

Add broth and tomatoes: Pour in the chicken or vegetable broth and add the canned diced tomatoes (with juices). Bring the mixture to a gentle boil.

Stir in tortellini: Once boiling, add the cheese tortellini to the pot. Cook according to package instructions (usually about 3-5 minutes) until the tortellini are tender.

Add cream and spinach: Slowly stir in the heavy cream and fresh spinach. Allow to simmer for another 2-3 minutes until the spinach wilts and the soup is heated through.

Season and serve: Season with salt and pepper to taste. Serve hot, topped with grated Parmesan cheese.