Bring a large pot of salted water to a boil. Cook the bowtie pasta according to package instructions until al dente. Drain and set aside.
In a large skillet, heat olive oil over medium heat. Add the chopped onion and cook until translucent, about 3-4 minutes.
Add the minced garlic to the skillet and sauté for an additional 1 minute until fragrant.
Increase the heat to medium-high and add the ground beef. Cook, breaking it apart with a spoon, until browned, about 6-8 minutes. Drain excess fat if needed.
Lower the heat to medium and stir in the heavy cream, Italian seasoning, red pepper flakes (if using), salt, and pepper. Let it simmer for about 3-4 minutes, allowing the sauce to thicken slightly.
Stir in the grated Parmesan cheese until melted and creamy.
Add the cooked bowtie pasta to the skillet and toss it in the creamy sauce, ensuring the pasta is well-coated.
Taste and adjust seasoning if necessary. Remove from heat.
Notes
Serve garnished with fresh basil and extra Parmesan cheese.