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In a large saucepan, cook fettuccine according to package directions; drain.
Meanwhile, melt butter (or margarine) in a large saucepan over medium-high heat. Add garlic; sauté for 1 minute. Add cream, salt and pepper. Bring to a boil; reduce heat. Boil gently, uncovered, for 3 minutes or until mixture begins to thicken. Remove from the heat and stir in 1/2 cup Parmesan. Drain pasta. Add pasta to hot sauce. Toss to combine. If desired, sprinkle each serving with additional Parmesan.