Bring a large pot of salted water to a boil. Cook the fettuccine according to package instructions until al dente. Reserve 1 cup of pasta water, then drain the rest and set aside.
In a large skillet over medium heat, melt the butter. Add the minced garlic and sauté for about 1 minute until fragrant but not browned.
Stir in the pumpkin puree and the heavy cream, mixing well to combine.
Add the grated Parmesan cheese, nutmeg, salt, and pepper. Stir until the cheese has melted and the mixture is creamy and well blended.
If the sauce is too thick, add some reserved pasta water a little at a time until desired consistency is reached.
Add the cooked fettuccine to the skillet, tossing gently to coat the pasta in the creamy pumpkin Alfredo sauce.
Serve immediately, garnished with chopped fresh parsley for a pop of color.
Notes
Garnish with fresh parsley for added flavor and color.