Begin by heating a large, heavy-bottomed skillet over medium heat. Add the Italian sausage and cook, breaking it up with a wooden spoon, until it is browned and cooked through.
Add the chopped onion and minced garlic. Cook for a few minutes, stirring often, until the onion is soft and translucent and the garlic is fragrant.
Stir in the cherry tomatoes and cook just until they begin to soften and release their juices.
Add the dry orzo directly to the pan and stir to coat it in the sausage and aromatics. Let it toast gently for one to two minutes.
Pour in the chicken broth and heavy cream, stirring well to combine. Bring the mixture to a gentle boil, then immediately reduce the heat to medium-low. Cook for about 10 minutes, stirring frequently to prevent the orzo from sticking to the bottom of the pan.
Once the orzo is tender, reduce the heat to low and stir in the kale. It will wilt quickly in the warm sauce, turning bright green and tender within a minute or two. Season with salt and freshly ground black pepper to taste.
Remove the pan from the heat and stir in the Parmesan cheese. Let the dish rest for a few minutes before serving.
Finish with additional Parmesan and a sprinkle of red pepper flakes, if you like a touch of heat.