Boil water in a large pot and cook pasta until al dente. Drain and set aside.
Melt butter over medium heat in a saucepan. Add garlic and cook until fragrant.
Stir in pumpkin puree and mix until smooth.
Pour in heavy cream and whisk until the sauce thickens slightly.
Add parmesan, nutmeg, sage, thyme, salt, and pepper. Stir until creamy.
Toss cooked pasta into the pumpkin Alfredo sauce until coated.
Serve warm with toppings of your choice.
Notes
Use brown butter for nutty flavor or coconut cream for a lighter option. Top with extra parmesan or fresh herbs. Store sauce separately if making ahead; reheat gently before serving.