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Fill a large stockpot with water and a generous pinch of salt. Bring to a boil and add fettuccine noodles, cooking a few minutes under package directions.
Meanwhile, in a large skillet, melt 3 tablespoons of the butter on low heat. Add the minced garlic and cook for 1-2 minutes until fragrant, stirring frequently so it doesn't burn. Keep the heat low!
Increase the heat to medium and whisk in the half-and-half; add half of the salt and pepper. Simmer for 1-2 minutes, then add 1/2 cup of the pasta water. Simmer for an additional 2-3 minutes until slightly reduced.
Add the grated parmesan cheese and the remaining butter, whisking until smooth and combined. Test the sauce for salt levels, adding more as needed.
Add the pasta into the sauce and toss to combine. Let the pasta simmer for 1-2 minutes until al dente. If the sauce is too thick (which may be the case especially if you used heavy cream), add additional pasta water 1-2 tablespoons at a time to loosen, stirring between each addition.
Serve immediately. Garnish with freshly chopped parsley as desired.