Add peach, rum (or vodka), coconut cream, lime juice, simple syrup, and pineapple juice to a blender; blend until smooth and creamy.
Fill a cocktail shaker halfway with ice, pour in the blended mixture, and shake about 15 seconds until well chilled.
Strain through a fine mesh strainer into a chilled glass.
Garnish with a peach slice or a sprinkle of toasted coconut and serve immediately.
Notes
Use ripe peaches (or frozen slices) for best flavor. If too thick, add a splash of pineapple juice; if too sweet, a touch more lime. For a zero-proof version, swap rum with coconut water. Chill your glass to keep the cocktail frosty longer.