As with most sauces originating from Italy, the early version of what we call an Alfredo sauce, is not what we Americans are accustomed to. A twist on cacio e pepe (starch water, pecorino and pepper), the authentic-ish version of Alfredo, called fettuccine al burro (with butter) is made with a generous portion of butter melted with Parmesan.
Where the version made with cream originated is not entirely certain. My guess is that, like with carbonara, some American just added a ton of cream to make it even more unhealthy.
Now, while I'll throw a hissy fit if my carbonara is thickened with cream instead of eggs, I like my Alfredo swimming in thick, velvety cream sauce. I would normally reduce the cream for 40 minutes or so to get the right consistency, but I either grew lazier or smarter, and now use a little flour to speed the process. This sauce really does come together in minutes, but unfortunately, I can’t make the pasta cook sooner!
Technique Tip: Use reserved pasta water to control the creaminess of the sauce.
Swap Option: Use Parmigiano-Reggiano instead of pecorino for a twist. Be sure to adjust the seasoning.
In a small bowl, mix the cheese, flour and pepper.2.
Add the heavy cream to a high-sided skillet and bring to a gentle simmer, over medium-high heat.3.
Add the cheese mixture and whisk to combine.4.
Allow the cream to return to a simmer and cook for 2 minutes, stirring constantly.5.
Season with salt, as needed.6.
Add the cooked fettuccine to the sauce and toss to combine.7.
Add reserved pasta water, as needed, until you achieve a creamy, velvety sauce.8.
Serve immediately with a some grated pecorino and freshly ground pepper.