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Cold pumpkin spice milk. Add the milk, pumpkin puree, honey, and pumpkin pie spice into a blender. Blend until smooth. Alternatively, put the ingredients in a large jar and blend with an immersion blender.
Warm pumpkin milk. If you desire a hot pumpkin drink, put all ingredients (except the garnishes) into a small saucepan. Heat on the stovetop over medium-high heat until warm and steaming. Whisk until everything is well combined.
Garnish. Pour the pumpkin milk into a glass or mug. You can serve as is or optionally top with a dollop of whipped cream and a sprinkle of pumpkin pie spice for garnish.
Serve. Serve right away and enjoy!