Cook the fettuccine: In a large pot of salted boiling water, add 12 ounces of fettuccine. Cook according to package instructions until al dente, usually around 10-12 minutes. Drain and set aside, reserving about ½ cup of the pasta water.
Sauté turkey sausage: In a large skillet over medium heat, heat 2 tablespoons of olive oil. Add 1 pound of sliced turkey sausage and cook until browned and cooked through, approximately 5-7 minutes. Remove the sausage from the skillet and set aside.
Cook garlic: In the same skillet, add 4 minced garlic cloves to the remaining oil. Sauté until fragrant, about 1 minute, being careful not to burn the garlic.
Create the sauce: Gradually pour in 1 cup of heavy cream and bring the mixture to a gentle simmer. Stir to combine, cooking for about 2-3 minutes until slightly thickened.
Add cheese: Incorporate 1 cup of grated Parmesan cheese into the sauce, stirring continuously until melted and smooth. Adjust the thickness by adding reserved pasta water if needed.
Combine all elements: Return the browned turkey sausage to the skillet and stir to combine. Add the cooked fettuccine, tossing gently to ensure the pasta is well coated in the creamy sauce.
Season: Taste the dish and season with salt and pepper to your liking. Serve hot, garnished with ¼ cup of chopped fresh parsley for added flavor and presentation.