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Preheat oven to 375°F (190°C). Grease a 9x13-inch baking dish and set aside.
Bring a large pot of salted water to a boil. Cook tortellini according to package instructions (usually 3–5 minutes). Drain and set aside.
In a large skillet over medium heat, cook the Italian sausage until browned and fully cooked, about 7–8 minutes. Use a spatula to break it into crumbles. Drain excess fat if needed.
Stir in the garlic and cook for 1 minute. Add Alfredo sauce, sour cream, Italian seasoning, salt, and pepper. Stir well and let it simmer for 2–3 minutes.
In a large bowl, combine the cooked tortellini and sausage Alfredo sauce. Stir in 1 cup of mozzarella cheese. Pour everything into the prepared baking dish.
Sprinkle the remaining ½ cup of mozzarella and the Parmesan cheese over the top. Bake uncovered for 20–25 minutes, or until hot, bubbly, and golden on top.
Let cool slightly before serving. Top with chopped parsley if desired.