1. Bring a large pot of salted water to a boil. Cook bowtie pasta until al dente, according to package instructions. Drain and reserve ½ cup of the pasta water.

2. In a large skillet over medium-high heat, add olive oil. Brown Italian sausage and ground beef until fully cooked. Remove from pan and set aside.

3. In the same skillet, melt butter over medium heat. Add minced garlic and sauté until fragrant, about 1 minute.

4. Pour in the heavy cream and stir to combine. Simmer for 3–4 minutes until slightly thickened.

5. Add fresh spinach to the sauce and cook until wilted, about 2 minutes. Add a splash of reserved pasta water if the sauce is too thick.

6. Return the sausage and beef to the skillet, then stir in the cooked pasta. Mix well to coat everything in the creamy sauce.

7. Sprinkle in the Parmesan cheese and season with salt, black pepper, and red pepper flakes if using. Toss again.

8. Serve immediately, garnished with more Parmesan or fresh herbs if desired.