Cook fettuccine pasta according to package directions. Reserve about 1 cup of pasta water before draining.
While pasta is cooking, melt butter in a large skillet over medium heat.
Add minced garlic to the skillet and cook for about 1 minute until fragrant, being careful not to burn it.
Pour in heavy cream and bring to a gentle simmer. Cook for about 3-5 minutes until it starts to thicken slightly.
Stir in the grated Parmesan cheese, salt, and pepper. Stir until the cheese is melted and the sauce is smooth.
Add the drained fettuccine to the skillet with the sauce. Toss to coat evenly. If the sauce is too thick, add a little reserved pasta water to reach desired consistency.
Serve immediately, garnished with extra Parmesan cheese if desired.
Notes
For an even richer sauce, you can add an extra tablespoon of butter or a splash more cream. Freshly grated Parmesan cheese makes a big difference in flavor!