Cook the fettuccine pasta according to package instructions in a large pot of salted boiling water. Drain and set aside, reserving 1/2 cup of pasta water.

In a large skillet, heat the olive oil over medium heat. Add the ground beef and cook until browned, breaking it up with a spoon, about 5-7 minutes. Drain excess fat if necessary.

Stir in the minced garlic, Italian seasoning, and red pepper flakes (if using). Cook for an additional 1-2 minutes until the garlic is fragrant.

Reduce the heat to low and pour in the heavy cream, stirring to combine. Add the Parmesan cheese and mix until melted and creamy.

Season with salt and pepper to taste. If the sauce is too thick, add a little reserved pasta water until desired consistency is reached.

Add the cooked fettuccine to the skillet, tossing to coat the pasta in the creamy sauce.

Serve immediately, garnished with chopped parsley.