The dish we know as Fettucine Alfredo here in the US evolved from a creamless recipe in Rome. The eponymous Alfredo di Lelio modified the traditional “fettuccine al burro,” which featured a sauce of Parmigiano-Reggiano and butter, to include even more butter, dubbing it “fettuccine al triplo burro.” When he eventually had his own restaurant near Piazza Navona (Alfredo alla Scrofa, at Via della Scrofa 104, Roma), patrons began to refer to this dish as Fettuccine all’Alfredo. Somewhere someone introduced cream to the ingredient list, and I am not complaining. By the way, we have been to the famous restaurant and did not think their current Alfredo was very good at all (too much cream, not enough nutmeg, so not great taste or consistency). This particular recipe comes from Marcella Hazan, an authentic Italian cook who emigrated to the USA and wrote some truly great books in the 1970's and onwards.
As noted on the Ingredients page, I get my Parmigiano-Reggiano directly from a dairy in Italy, but the heavy cream I get from a local dairy with grass-fed cows. Real parmigiano-reggiano and grated nutmeg are more important than getting the freshest cream, so don't let that hold you back.
My family prefers store-bought maccheroni over homemade for this particular recipe. I like both. If you would like to try it with homemade fettuccine, I recommend the semola version of the pasta all'uovo and that you be careful not to overcook it. It needs to be al dente for this recipe. Note that it will cook very slightly more as you mix it on low heat, so err a little on the side of al dente. This is something I always struggle with getting right.
All that said, this is an extremely fast and simple recipe to make when you are in a hurry!
1 lb (453 g, but 500 g is fine) fettuccine (Giuseppe Cocco or De Cecco) or other pasta of your liking
1 cup (240 g) heavy cream (ideally from a local dairy)
3 Tbsp (43 g) unsalted butter
1/2 tsp (3 g) salt
3/4 cup (75 g) grated Parmigiano-Reggiano, aged no more than 3 years
Freshly ground black pepper, to taste
Half a nutmeg, grated finely (freshly grated nutmeg makes all the difference!)
1. Put roughly two-thirds of the heavy cream and all of the butter in a pot (e.g., an enamel-covered cast-iron one). Simmer until thickened. Turn off heat.
2. In the meantime, cook pasta according to directions on the package (macaroni) or in the recipe (homemade). Drain.
3. Transfer pasta to the pan with the sauce. Mix over low heat to coat the fettuccine well.
4. Mix in the salt, pepper, and nutmeg (I keep these all on the same plate).
5. Add the remaining third of the cream and all the cheese. Toss until sauce has thickened. If it seems a little dry, add a little more cream.
6. Serve immediately, with extra cheese on the side.