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. 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.
By the way, we have been to Alfredo's famous restaurant in Rome and did not think its current recipe was very good at all - service was good, but food was generally very mediocre and way overpriced. I guarantee you will like the recipe below more.
This recipe is incredibly easy to make—and so good we double for leftovers. Tailoring to my preferences, I have reduced the amount of heavy cream and increased the Parmigiano; however, my daughter insists the original amounts are superior, so I’ve included those as well.
1 lb fettuccine (packaged De Cecco or homemade)
3/4 cup heavy cream (original recipe was 1 cup)
3 Tbsp butter
1/2 tsp salt
3/4 cup grated Parmigiano-Reggiano (original recipe was 2/3 cups)
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 fettuccine according to directions on the package (macaroni) or in the recipe (homemade). Drain.
3. Transfer fettuccine to the pan with the sauce. Mix over low heat.
4. Add the remaining third of cream and the salt, pepper, nutmeg, and cheese. Toss until sauce has thickened.
5. Serve immediately, optionally with extra cheese and grated nutmeg on the side.