In a large pot, bring salted water to a boil. Add the bowtie pasta and cook for 8–10 minutes or until al dente, reserving ½ cup of pasta water, then drain.

Heat a skillet over medium-high heat and melt 1 tablespoon of butter. Add the ground beef, sprinkle with Cajun seasoning, salt, pepper, and optional red pepper flakes. Cook for about 5–7 minutes until browned.

Reduce heat to medium, add remaining 1 tablespoon of butter to the skillet. Once melted, add minced garlic, sautéing until fragrant. Incorporate softened cream cheese, then whisk in milk or half-and-half.

Stir in grated Parmesan cheese and remaining Cajun seasoning, simmering the sauce for 2–3 minutes until it thickens slightly.

Return cooked ground beef and drained pasta to the skillet. Toss together, adding reserved pasta water as needed to reach desired consistency.

Plate immediately, garnishing with extra Parmesan, parsley, or red pepper flakes.