Bring a large pot of water to a boil and cook the fresh cheese tortellini according to the package directions. Fresh tortellini usually cooks quickly, so watch it carefully. Drain without rinsing and set aside.

While the tortellini cooks, place a large skillet over medium heat. Add the ground beef, diced onion, and minced garlic.

Cook until the beef is completely cooked through and lightly browned, breaking it into small pieces with a wooden spoon as it cooks. Drain excess grease if necessary.

Add the butter to the skillet. Once melted, sprinkle in the flour and stir thoroughly so it combines evenly with the beef.

Pour in the heavy cream, then add the diced tomatoes, chopped spinach, fresh basil, Italian seasoning, salt, black pepper, and Parmesan.

Stir everything together and bring the sauce to a gentle boil. Reduce the heat to medium-low and simmer for about 5–6 minutes, stirring occasionally, until the creamy tomato sauce thickens slightly.

Add the cooked tortellini to the skillet and gently toss until every piece is coated in the sauce. Your Ground Beef Tortellini is ready when the pasta is heated through and the sauce is creamy.

Serve immediately with additional grated Parmesan and fresh basil if desired.