Combine the coconut milk, pumpkin puree, maple syrup, cinnamon, and ginger in a saucepan. Bring to a boil over high heat, then reduce the heat to low.
Stir in the tapioca pearls and simmer, stirring frequently, for about 12 minutes, until the pearls turn translucent and the pudding thickens.
Divide the tapioca pudding evenly between four small dishes. Refrigerate for 2 hours until the pudding sets.
Serve chilled with a garnish of coconut cream, a drizzle of caramel sauce, roasted coconut flakes, and a pinch of cinnamon.
Notes
Coconut cream: coconut cream can be scooped up from a can of full fat coconut milk that has been refrigerated for 24 hours. The coconut cream separates from the coconut water with the cold. I love to use this brand of coconut milk. It is rich and creamy and makes the best coconut cream! You can find it on Amazon or at your local Asian store.