In a large pot, bring salted water to a boil. Add the cheese tortellini and cook according to package instructions until al dente, usually about 3-5 minutes for fresh or 7-9 minutes for frozen. Drain and set aside.
In a large skillet, heat the olive oil over medium heat. Add the minced garlic and sauté for about 1 minute until fragrant, being careful not to let it burn.
Add the cherry tomatoes to the skillet and cook for 3-4 minutes until they start to soften. Stir occasionally.
Reduce the heat to low and pour in the heavy cream, stirring to combine with the garlic and tomatoes.
Mix in the basil pesto and grated Parmesan cheese, stirring until the cheese is melted and the sauce is creamy.
Add the cooked tortellini to the skillet, tossing it in the creamy pesto sauce to coat evenly.
Gently fold in the fresh spinach and heat for an additional 2-3 minutes until the spinach wilts.
Season with salt and pepper to taste.
Notes
Serve in shallow bowls, garnished with fresh basil leaves and extra Parmesan cheese.