How to Make Classic Fettuccine Alfredo

Getty Images

Roman restaurateur Alfredo di Lelio concocted fettuccine Alfredo a hundred years ago for his wife, who was recovering after giving birth. The sauce of Parmesan, butter, and cream was designed to comfort as well as satiate. And that’s precisely what the perennially popular dish has been doing on this side of the Atlantic ever since it was made fashionable by Mary Pickford and Douglas Fairbanks, the Brangelina of the silent-film era.

“They dined on this dish every night,” Lidia Bastianich, the doyenne of Italian-American cuisine and chef-owner of a half dozen acclaimed restaurants, says of the couple’s 1920 honeymoon in Rome. “After they returned home, they shared it with their friends in Hollywood and, by the 1930s, American restaurateurs were creating new versions.”

Despite becoming a hit in America, the dish fettuccine Alfredo – based on the Italian classic “pasta with butter and Parmesan” – is virtually unknown in Italy. Predictably, the American dish is now served in a variety of ways and modern cooks are endlessly coming up with personalized takes. Bastianich, in her recipe from Lidia’s Italy in America, adds fragrant sage leaves “to give it a fresh herb element.” Leave them in or take them out; her sauce will still be extraordinary. The dish becomes a full meal if you add parcooked spring peas, asparagus tips, or broccoli florets. If you like, also add a protein such as shrimp.

A good fresh or homemade egg fettuccine would be phenomenal with this Alfredo sauce, but you could just as well experiment with dry pastas, from spinach fettuccine, spaghetti, and bucatini to short pastas such as fusilli, ziti, or penne. Bastianich produces her own artisanal dry pasta, but she gives Rustichella high marks as well.

Lidia Bastianich’s Fettuccine Alfredo
(Serves 6)


  • 1 tsp kosher salt, plus more for pasta pot
  • 1 pound dried fettuccine
  • 2 cups heavy cream, or half-and-half
  • 4 tbsp unsalted butter
  • 10 fresh sage leaves
  • 1/2 cup grated Grana Padano or Parmigiano-Reggiano cheese
  • Optional: small or cut-up parkcooked vegetables such as spring peas, broccoli florets, or asparagus tips; protein such as shrimp


Step One
Bring a large pot of salted water to boil for pasta. When you are ready to begin the sauce, slip the fettuccine into the water.

Step Two
In a large skillet, combine the cream, 1 cup pasta cooking water, the butter, sage, and half of the grated cheese over medium heat. Stir to melt the butter, and bring just to a simmer. Add optional vegetable and/or protein now. Let simmer lightly for a minute or two so the sage leaves infuse the cream. The sauce congeals rapidly; to loosen it up, add a few tablespoons of the pasta cooking water and stir rapidly.

Step Three
When the fettuccine is al dente, transfer it directly to the skillet with the simmering sauce. Season with the salt and return to a simmer. Simmer, tossing with the tongs, just until the sauce begins to coat the pasta, another minute or two. Remove from heat, sprinkle with the remaining grated cheese, and toss. Serve immediately.

For access to exclusive gear videos, celebrity interviews, and more, subscribe on YouTube!