Rinse the broccoli under cold water, chop into small florets, soak briefly in cold water, drain, and set aside.

In a large pot, bring salted water to a boil. Add orecchiette and cook according to package instructions, reducing time by 2 minutes. Reserve about 2 cups of pasta water before draining.

In a large skillet, heat olive oil over medium-high heat. Add sausage, breaking it up. Cook for 5 to 6 minutes until browned and cooked through.

Add chopped broccoli and minced garlic to the skillet, stir well, and cook for an additional 5 to 6 minutes until broccoli is bright green and tender. Add reserved pasta water if needed.

Drain the pasta, add to the skillet with sausage and broccoli, pour in reserved pasta water. Toss to coat the pasta.

Continue tossing over medium heat, adding more pasta water as needed to create a creamy consistency.

Remove from heat and serve hot, garnished with Parmesan cheese, olive oil, and optional red pepper flakes.