Bring a large pot of salted water to a boil. Cook the fettuccine according to package directions until al dente, about 8-10 minutes. Reserve 1/2 cup of pasta water, then drain the pasta.
In a saucepan, melt 4 tablespoons of butter over medium-low heat. Add the heavy cream and simmer for 4-5 minutes until slightly thickened.
Whisk in the parmesan cheese until melted and smooth. Season with salt and pepper to taste.
In a large skillet, heat the remaining tablespoon of butter over medium-high heat. Add the shrimp and season with salt and pepper. Cook for 3-4 minutes until pink and opaque.
Add the minced garlic and cook for an additional 30 seconds.
Combine the cooked fettuccine with the shrimp and Alfredo sauce. Toss gently to coat, adding reserved pasta water as needed to thin the sauce.
Arrange shrimp on top of the pasta and sprinkle with chopped parsley before serving.
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Notes
Store leftovers in an airtight container in the refrigerator for up to 2-3 days.