Bring a large pot of salted water to boil. Cook fettuccine according to package instructions until al dente.
In a large skillet, melt butter over medium heat. Add minced garlic and sauté until fragrant, about 1-2 minutes.
Pour in heavy cream and bring to a simmer. Cook for 5 minutes until slightly thickened.
Stir in Parmesan cheese until melted and sauce is smooth. Season with salt and pepper.
Add cooked pasta to the sauce and toss until well coated. Serve hot with extra Parmesan if desired.