Bring a large pot of salted water to a boil and cook tortellini according to package instructions. Drain and set aside.
- In a large skillet, heat olive oil or butter over medium-high heat. Add ground beef and cook until browned. Drain excess fat if needed, then stir in Cajun seasoning and cook 1–2 minutes to toast the spices. Remove beef and set aside.
- Reduce heat to medium. In the same skillet, sauté garlic in butter or oil until fragrant, about 30 seconds.
- Pour in heavy cream and bring to a gentle simmer. Stir in cream cheese (if using) and Parmesan, whisking until smooth and creamy. Season with salt and pepper to taste.
- Return cooked beef and tortellini to the skillet. Toss well to coat in the Alfredo sauce. Simmer 2–3 minutes to thicken and meld flavors.
- Serve hot, garnished with parsley, red pepper flakes, and extra Parmesan or mozzarella if desired.