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Bring a large pot of salted water to a boil, cook the fettuccine until al dente. Reserve 1 cup of pasta water, then drain.
In a large pan, melt the butter over low heat. Add the minced garlic and sauté for 30 seconds until fragrant.
Add the heavy cream and gently simmer for 2 minutes. Add salt and pepper as needed (don't add too much salt as the parmigiano reggiano is salted).
Add the hot pasta directly into the sauce.
Add the grated parmigiano reggiano, and slowly start splashing the reserved pasta water until you get a glossy, creamy sauce.
Serve immediately with extra parmigiano and freshly cracked black pepper and enjoy.