Heat a large deep skillet over medium-high heat. Add ground beef and cook until browned, breaking it up with a spoon. Drain excess fat if needed.

Add the diced onion to the skillet and sauté for 3-4 minutes until softened. Add garlic and cook for 30 seconds until fragrant.

Stir in the tomato paste and dry orzo. Cook for 1-2 minutes to toast the orzo slightly.

Pour in the beef broth and tomato sauce. Add Italian seasoning, salt, and pepper. Stir well to combine.

Bring to a boil, then reduce heat to low. Cover and simmer for 10-12 minutes, stirring occasionally to prevent sticking, until orzo is al dente.

Stir in the heavy cream and fresh spinach. Cook for 1-2 minutes until spinach is wilted and sauce is creamy.

Remove from heat and stir in the parmesan cheese. Serve immediately.