Heat a little cooking oil in your pan over medium-high heat. Add chopped onion and minced garlic, stirring until translucent. This step releases their sweet, savory flavors, forming the base of the sauce.
Add ground turkey and break it apart with a spatula. Cook until no pink remains and the meat starts browning. I like to drain excess grease using a paper towel for a lighter dish.
Sprinkle in Italian seasoning, salt, and pepper, then toss the uncooked orzo. Cook for a minute to coat the pasta with spices. This helps the orzo absorb more flavor as it simmers.
Pour in tomato sauce, water, and heavy cream. Bring to a boil, then reduce to a gentle simmer. Stir often for 10 minutes until the orzo is tender and creamy.
Remove from heat and fold in parmesan and baby spinach. Cover for 3–4 minutes to let the cheese melt and the spinach wilt. Serve hot, garnished with parsley if desired.