Boil the pasta. Bring a large pot of salted water to a boil. Add pasta and cook until just shy of al dente.
Reserve about 1 1/2 cups of the starchy pasta water before draining.
Prep the garlic. While the pasta cooks, mince or thinly slice the garlic. Keep it consistent so it cooks evenly.
Sauté gently. In a large skillet over medium-low heat, melt 2–3 tablespoons of butter. Add the garlic and a pinch of red pepper flakes if using.
Cook 1–2 minutes until fragrant and pale golden. Don’t let it brown.
Build the sauce. Add 1/2 cup of cream (or 2/3 cup milk) to the skillet. Stir and let it warm through. Season lightly with salt and black pepper.
Emulsify. Add the drained pasta to the skillet.
Pour in 1/2 cup of reserved pasta water and toss. Add another tablespoon of butter and keep tossing until the sauce looks glossy and coats the noodles.
Add the cheese. Off the heat, sprinkle in 1/2 cup finely grated Parmesan or Pecorino. Toss quickly to melt and thicken the sauce.
If it’s too thick, add more pasta water a splash at a time.
Finish and brighten. Taste and adjust seasoning. Add a small squeeze of lemon if you like, or a final spoonful of butter for extra richness. Top with chopped parsley or chives.
Serve right away. Creamy sauces are best hot.
Twirl into bowls and finish with extra cheese and black pepper.