Step 1

In a Dutch oven, add the sausage and the onion, crumbling the sausage.

Step 2

Over medium heat, cook the sausage, while stirring, until it is no longer pink, about 5-7 minutes.

Step 3

Add the garlic to the cooked sausage and cook until fragrant, about 1 minute.

Step 4

Stir the broth, the water, and the tomatoes into the sausage mixture and bring to a boil.

Step 5

Add the tortellini to the broth mixture.

Step 6

Return the broth mixture to a boil and cook, stirring occasionally, until the tortellini are almost tender.

Step 7

Reduce the heat to low-medium.

Step 8

Add the spinach, the basil, the pepper, and the red pepper flakes to the broth mixture.

Step 9

Cook the soup until the spinach is wilted and the tortellini are tender, about 2-3 minutes.

Step 10

Serve with the cheese.