01 - Bring a large pot of salted water to a boil. Add the fettuccine and cook according to package instructions until al dente. Reserve 1/2 cup pasta cooking water, then drain the pasta.
02 - Melt butter in a large skillet over medium heat. Add minced garlic and sauté for 1 to 2 minutes until fragrant but not browned.
03 - Pour in heavy cream and bring to a gentle simmer. Cook for 3 to 4 minutes, stirring occasionally.
04 - Reduce heat to low. Gradually whisk in grated Parmesan until the sauce is smooth. Season with black pepper, salt, and nutmeg if using.
05 - Add drained fettuccine to the skillet and toss to coat evenly with the sauce. If sauce is too thick, add reserved pasta water to desired consistency.
06 - Plate immediately, garnishing with chopped parsley and additional Parmesan as preferred.