In large pot over medium heat, cook sausage until lightly browned and warmed. Remove from pot and drain.

Return pot over medium heat, add butter and garlic. Stir and sauté until fragrant.

Add in spinach and cook 3-4 minutes.

Add in flour, stir and cook for 1-2 minutes.

Gently pour in heavy cream, paprika, salt and pepper and stir until combined, bring to a simmer.

Once slightly thickened, add in reserved pasta water. Stir and return to a simmer.

Add in fresh parmesan and stir.

Return cooked pasta to pot and stir to coat pasta. Add back sausage and stir again.

Top with a little more parmesan and enjoy!