Prepare the ingredients: peel and devein the shrimp if they still haven't been already, slice the cherry tomatoes in half, and chop the basil.
Cook the pasta according to package instructions.
Meanwhile, heat a pan on medium-high heat with olive oil and sauté the garlic for 1-2 minutes until fragrant. Then add the pesto, heavy cream, and red pepper flakes. Stir until combined and then add the shrimp and cook 2-3 minutes per side until they are cooked through.
When the pasta is finished cooking, reserve 1/4 cup of the pasta water, then drain the pasta into a colander. Add the pasta back into the pot with the reserved pasta water, the basil pesto sauce, shrimp, and cherry tomatoes. Toss to combine. Divide between bowls and garnish with fresh chopped basil and parmesan cheese.
*Nutrition information is approximate and was calculated using a recipe nutrition label generator.