Cook the Pasta: In a large pot, bring salted water to a boil. Add the bowtie pasta and cook according to the package directions until al dente, usually about 10-12 minutes. Drain and set aside.

Cook the Beef: In a large skillet or pan, heat olive oil over medium-high heat. Add the ground beef and cook, breaking it apart with a spatula, until browned and cooked through, about 5-7 minutes. Drain excess fat if necessary.

Sauté Onion and Garlic: Add the chopped onion to the skillet with the beef and cook until softened, about 3 minutes. Add the minced garlic and cook for another 30 seconds until fragrant.

Add Seasonings: Stir in the Italian seasoning, salt, pepper, and Worcestershire sauce (if using). Cook for another minute to combine the flavors.

Make the Cream Sauce: Lower the heat and pour in the beef broth, scraping up any brown bits from the bottom of the pan. Stir in the heavy cream and bring the mixture to a simmer. Let it cook for 3-4 minutes, allowing the sauce to thicken slightly.

Finish the Sauce: Stir in the Parmesan cheese and sour cream (if using), mixing until the sauce becomes smooth and creamy. Taste and adjust seasoning if needed, adding more salt, pepper, or garlic powder.

Combine with Pasta: Add the cooked bowtie pasta to the skillet with the beef and cream sauce, tossing to coat the pasta evenly. If the sauce is too thick, add a splash more of beef broth or cream to reach your desired consistency.

Serve and Garnish: Serve the creamy beef and bowtie pasta immediately, garnished with fresh parsley and extra grated Parmesan if desired.