Bring a large pot of salted water to a boil. Add fettuccine and cook for 8-10 minutes until al dente. Reserve 1 cup pasta water, then drain.

In a skillet, melt butter over medium-low heat. Add minced garlic and sauté for about 1 minute until fragrant.

Lower heat, stir in half & half, pumpkin puree, and nutmeg. Warm for 3-5 minutes until slightly thickened.

Add Parmesan cheese to the skillet, stirring until melted and creamy.

Gradually add reserved pasta water to reach desired consistency.

Toss drained fettuccine in the skillet with the sauce for 2-3 minutes, ensuring it's evenly coated.

Plate the pasta and garnish with Parmesan, parsley, and toasted pumpkin seeds.