Begin by bringing a large pot of salted water to a rolling boil over high heat. Add the fettuccine, stirring occasionally, and cook until al dente—about 8-10 minutes.

While the pasta cooks, heat a large skillet over medium heat and add a pat of butter. Once melted, toss in minced garlic, sautéing until fragrant, about 1-2 minutes.

Stir in pumpkin puree and heavy cream into the skillet with the garlic, mixing well to combine. Reduce heat to low, simmer for about 3-5 minutes until heated through and smooth.

Gradually whisk in freshly grated Parmesan cheese into the pumpkin Alfredo sauce, stirring continuously until it melts and creates a creamy texture.

Toss the drained fettuccine into the skillet, gently mixing the pasta with the creamy sauce over low heat for about 1-2 minutes.

Once combined, plate the pasta, garnishing with chopped parsley or sage and toasted pumpkin seeds.