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Cook Pasta: Bring a large pot of salted water to a boil, then add your fettuccine and cook until al dente. Reserve 1 cup of pasta water before draining.
Brown Beef: Heat a large skillet over medium heat. Add the lean ground beef, breaking it apart, and season with salt, pepper, and Italian seasoning until no pink remains.
Sauté Aromatics: Push the beef to one side of the skillet. Add the minced garlic to the cleared space and sauté for about one minute until fragrant.
Build Sauce: Pour in the heavy cream, stirring to combine it with the beef and garlic. Gradually whisk in the Parmesan cheese until the sauce is smooth and creamy.
Wilt Spinach: Add the fresh spinach to the skillet, stirring gently until it wilts down completely into the luscious sauce. This may require several batches.
Combine & Finish: Add the drained pasta to the skillet with the sauce. Toss everything together until the pasta is beautifully coated. Add reserved pasta water, a little at a time, to reach your desired creamy consistency.