Bring a large pot of water to a boil. Add salt (about 1 to 2 tablespoons), stir, and bring back to a boil. Add the fettuccine and cook according to package instructions. Prepare the sauce while the pasta is cooking.

In a large skillet, melt the butter over medium heat. Add the cream to the melted butter and stir to combine. Turn the heat to low.

Add the cooked (al dente) fettuccine to the pan directly from the water. Do not drain. Reserve the pasta cooking water.

Increase the heat to medium and toss the pasta to coat it with the sauce. Add half of the cheese and toss. Add a ladel or a couple of spoonfuls of pasta water and toss. Add the rest of the cheese and toss. Add more pasta water as needed. The sauce may seem soupy at first. The pasta will absorb it quickly and can easily become dry. Add and stir in more pasta water and it will become creamy again.

Serve with additional Parmesan cheese as a garnish.