Cook the pasta Boil fettuccine in salted water until al dente. Reserve 1/2 cup pasta water, then drain.
Cook the shrimp Season shrimp with salt, pepper, and paprika. Heat oil or butter in a skillet and cook shrimp 1–2 minutes per side until pink. Remove and set aside.
Make the Alfredo sauce In the same skillet, melt butter over medium heat. Add garlic and cook 30 seconds. Stir in heavy cream and simmer for 3–4 minutes.
Add Parmesan Whisk in Parmesan cheese until smooth and creamy. Season with salt, pepper, and nutmeg if using.
Combine everything Add cooked pasta and shrimp to the sauce. Toss until coated. Use reserved pasta water if needed to loosen the sauce.
Serve Garnish with parsley and extra Parmesan.
Tips
Freshly grated Parmesan melts smoother than pre-shredded cheese.
Don’t overcook shrimp — they cook very quickly.
Add spinach or mushrooms for extra flavor and texture.