Cook the Pasta: Prepare the pasta according to the package instructions. Bring a large pot of salted water to a boil, add pasta, and cook until al dente. Drain the pasta well, reserving about 1/4 cup of pasta water in case you need to thin the sauce later.
Prepare the Sauce: In a large skillet, melt the butter over medium heat. Add the minced garlic and sauté for 1-2 minutes until fragrant but not browned. This creates an aromatic base for your sauce.
Create the Pumpkin Cream Sauce: Stir in the pumpkin puree, heavy cream, and Parmesan cheese to the garlic butter mixture. Season with salt, pepper, and a pinch of nutmeg to enhance the flavor profile of the pumpkin. Combine all ingredients thoroughly.
Simmer and Thicken: Let the sauce simmer for 5-7 minutes, stirring occasionally to prevent burning. The sauce will gradually thicken and become creamy as the ingredients meld together. If the sauce becomes too thick, add a splash of the reserved pasta water.
Combine and Serve: Add the cooked pasta to the skillet with the pumpkin sauce. Toss gently until all pasta is well coated with the creamy sauce. Serve immediately, garnished with extra grated Parmesan cheese if desired.