Preheat oven to 350 degrees. Grease a 9x13 inch baking dish.
In a large saucepan, bring chicken broth to a boil. Add orzo and cook for 8 minutes (orzo will finish cooking in the oven).
Transfer orzo and broth mixture to a large mixing bowl and stir in meatballs, spinach, Alfredo sauce, pesto and salt and pepper, to taste. Add the mixture to the prepared baking dish.
Top with Parmesan cheese. Bake at 350 degrees for 25-30 minutes, or until bubbly and cheese has melted on top. Serves 6-8.