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Fettuccine Pasta Alfredo with Shrimp

Simple cream, butter, and Parmigiano-Reggiano cheese create this decadent sauce. Fresh shrimp are quick sauteed with garlic and juicy, ripe tomato with a squeeze of lemon garnish and bring brightness to this classic pasta combination.
Prep Time10 mins
Cook Time15 mins
Total Time25 mins
Course: Main Course
Cuisine: Italian, Italian American
Keyword: Fettuccine Pasta Alfredo with Shrimp
Servings: 4
Calories: 685kcal


  • 1 pound shrimp, peeled and deviened
  • 1 tablespoon butter
  • 2 cloves garlic - finely minced or grated
  • 1/8 teaspoon red pepper flakes
  • 1/2 cup tomato - very ripe, diced
  • 8 ounces fettuccine pasta cooked to package directions

Alfredo Sauce

  • 1/4 cup butter
  • 1 cup cream, heavy
  • 1/2 teaspoon salt
  • 1/4 teaspoon pepper - fresh cracked/ground
  • 1/2 cup Parmigiano-Reggiano cheese - fresh grated


  • Bring a large pot of well salted water to boil and cook pasta to al dente directions on the package.
  • Heat a large skillet or fry pan to high and add 1 tablespoon butter.  When the butter foams, add the shrimp in a single layer to the pan.
  • Cook for 1-2 minutes and flip the shrimp.  Add the garlic and crushed red pepper flakes and cook for 1 more minute, just until the shrimp are cooked through (no longer translucent).  Be very careful to not overcook the shrimp as they may become rubbery.
  • Remove the shrimp from the hot fry pan.
  • Turn the heat down the medium and add the remaining butter to the pan.  Add the cream, salt, and pepper and stir continuously until the butter is melted and the mixture begins to steam.
  • Start whisking in the Parmigiano-Reggiano cheese a bit at a time.  When all of the cheese has been added and melted, remove from the heat.
  • The sauce may be mixed in with the pasta or served over the top.
  • Top with the shrimp and the diced tomato.  Sprinkle with grated or shredded Parmigiano-Reggiano cheese, fresh cracked black pepper, and a lemon wedge.


Cream - choose heavy cream, whipping cream, country style, or double cream when selecting among cream choices.
Nutrition information is approximate.


Calories: 685kcal | Carbohydrates: 45g | Protein: 36g | Fat: 39g | Saturated Fat: 23g | Cholesterol: 406mg | Sodium: 1501mg | Potassium: 317mg | Fiber: 2g | Sugar: 2g | Vitamin A: 1500IU | Vitamin C: 8mg | Calcium: 369mg | Iron: 3.3mg