Begin by bringing a large pot of salted water to a rolling boil over high heat. Add 12 ounces of your favorite pasta, stirring occasionally, and cook until al dente, usually about 8-10 minutes. Reserve 1 cup of the starchy pasta water, then drain the rest and set the pasta aside while preparing the sauce.

In a large skillet, heat 2 tablespoons of olive oil over medium heat. Add 2 cloves of minced garlic and sauté for 1-2 minutes until fragrant and golden.

Stir in 1 cup of pumpkin puree into the skillet, mixing it with the garlic. Cook for about 2-3 minutes, allowing the pumpkin to warm through. Gradually pour in 1 cup of heavy cream while continuously stirring, ensuring the mixture becomes smooth.

Add ¾ cup of grated Parmesan cheese, ½ teaspoon of ground nutmeg, ½ teaspoon of salt, and ¼ teaspoon of black pepper to the skillet. Stir until the cheese melts completely and the sauce thickens.

Gently toss the drained pasta into the creamy sauce, ensuring each strand is thoroughly coated.

Transfer the coated pasta to serving plates or bowls, garnishing with additional grated Parmesan cheese and freshly chopped parsley or sage as desired. Serve immediately.