How do I go from .xlsx to sql Server I'll try my best to explain this.
I've got a spreadsheet (.xlsx) with 220 rows and 15 columns. I need to make it into 3rd normalized form eventually, but how do I get the data from the spreadsheet into a database so I can start changing it? I've tried looking on Google but I can't find anything.

(If this is not where this question please link me to correct direction and I'll close the question)
You can use Excel to save the file as a .CSV (comma-separated-values), and use SQL Server Management Studio to import the file either into an existing table, or potentially a new table.

In SQL Server Management Studio, you select the desired target database, right-click the database name, then click 'Import Data', and go through the wizard step-by-step.