Gather ingredients: fettuccine, butter, heavy cream, garlic, Parmesan cheese, salt, black pepper, and pasta water
Bring a large pot of salted water to a boil
Cook the pasta until al dente
Reserve some pasta water before draining
Melt butter in a large skillet over medium heat
Add minced garlic and cook briefly until fragrant
Pour in heavy cream and simmer gently
Stir in grated Parmesan cheese until smooth
Season with salt and black pepper
Add cooked pasta to the sauce
Toss to coat, adding reserved pasta water as needed
Serve immediately with extra Parmesan if desired