Begin by bringing a large pot of salted water to a vigorous boil over high heat. Add fettuccine pasta and cook according to package instructions.

Reserve about ½ cup of starchy pasta water before draining.

In a large skillet, heat olive oil over medium heat. Add shrimp, season with salt, pepper, and optional red pepper flakes. Cook for 2-3 minutes on each side until pink and opaque, then remove from skillet.

Lower heat and add minced garlic to the skillet. Sauté for about 1 minute until fragrant and golden.

Pour heavy cream into the skillet with garlic and simmer for about 2-3 minutes.

Gradually whisk in Parmesan cheese until melted and sauce is smooth. Adjust consistency with reserved pasta water as needed.

Combine cooked fettuccine and sautéed shrimp with the Alfredo sauce, tossing gently to coat.

Serve hot, garnished with chopped parsley and additional Parmesan if desired.