Healthy Fettuccine Alfredo

I’ve been making a mess lately.

Healthy Fettuccine Cauliflower Alfredo

A mess that starts with slurpy delicious noodles and ends with creamy fettuccine alfredo sauce.

I’m of the belief that Alfredo sauce is King. Even deep red tomato sauces (which are supposed to be deep and red) are at their best with the addition of a little cream. Which makes them not deep red anymore and more like a pinky-orange. Pink is fun, right? It’s just like I just try to make everything into Alfredo. That’s just what it’s like.

The truth about Fettuccine Alfredo, besides the truth that it’s the most cozy and comforting food known to humans, is that it has no business being in my life after I’ve spent the last 8 meals filling up on corn, pumpkin bars, and stuffing. And PS: thank goodness that stuff makes great leftovers considering my Gatorade and cracker sickie Thanksgiving eats. If I may digress for a second, why is stuffing And with gravy? Ugh. The glory of eating again.

Cauliflower in a pan.

Ok, so that picture. That was cauliflower.

Because this Fettuccine Alfredo is made with cauliflower.

AND, you guys. Now I am going to eat it forever.

Who knew that cauliflower puree could make an Alfredo sauce that is still really creamy and slurpy and cozy comfy good! And I can eat it anytime I want, even the week after Thanksgiving, because it’s not made with heavy cream and butter. Except there’s just a teeny bit of cream and butter, because what is Alfredo – even fake Alfredo – without cream and butter?

But come on. Considering that most of this sauce is VEG-ET-ABLES, well, I don’t know, you tell me.

Tell me I should eat it every night. I dare you.

Creamy cauliflower sauce in a skillet with a wooden spoon.

My mom brought me some fancy noodles when she came to visit – you know, the kind they sell at specialty boutiquey food stores that make you feel like quitting your life and moving to Italy and making homemade ice cream for the rest of time? Or the kind that somehow suck your money out of your purse and plant mass quantities of artisan chocolate bars in their place? Salted Toffee Dark Chocolate, anyone?

But the noodles. They were SWEET POTATO fettuccine noodles and they were kind of spicy, like Christmas-y nutmeg spicy. Those noodles with this sauce? It was the most amazing, comforting combination of textures, flavors, and spices in one big ol’ bowl of pasta.

Fettuccine alfredo in a skillet with a wooden spoon.

You would be wise to make this happen if you’re into the whole noodles and creamy sauce thing.

Fettuccine alfredo on a white plate with a fork.
cauliflower alfredo

Healthy Fettuccine Alfredo


This healthy fettuccine alfredo is made with a creamy cauliflower sauce that tastes just like the real thing. Simple ingredients, amazing flavor!


  • 1 lb. uncooked fettuccine noodles
  • 3 small heads cauliflower
  • 6 cups vegetable broth
  • 6 cloves garlic, minced
  • 1 tablespoon butter
  • 1 teaspoon salt
  • pinch of nutmeg
  • pinch of black pepper
  • 1 tablespoon olive oil
  • 1/4 cup heavy cream
  • 1 cup starchy boiling water from pasta pot


  1. Chop the cauliflower. Bring the vegetable broth to a boil over medium high heat and add cauliflower. Cook until cauliflower is soft, about 15 minutes. In my experience, the longer you cook it, the smoother the sauce will be. Meanwhile, melt the butter in a large skillet over medium heat. Add the minced garlic and saute for 4-5 minutes or until soft and fragrant.
  2. As the garlic and cauliflower are cooking, bring a large pot of water to boil and cook the fettuccine according to directions on package, reserving some of the starchy water to add to the sauce later.
  3. Transfer cauliflower to a blender with about 2 cups of the broth. You may need to do this in batches depending on the size of your blender. Add the sauteed garlic, salt, nutmeg, and black pepper and puree until very smooth, about 5 minutes. Once the mixture is moving, stream the olive oil into the blender. Add more broth or water if the mixture is too thick to move through the blender. You want it to turn through the blender easily. When puree is very smooth, transfer back to the butter/garlic skillet.
  4. Add the cream and cook over low heat. Add the starchy pasta water (or regular water if you’re not making pasta) and keep warm until ready to serve. Combine noodles and sauce in a large pot or skillet and serve immediately.


The sauce will “dry out” a little bit as it cools on the pasta. Adding a little water to the leftovers will help make it creamy again. Serving size is 1/8 of the noodles with about 1 cup of sauce.

  • Prep Time: 15 mins
  • Cook Time: 15 mins
  • Category: Dinner
  • Cuisine: Italian

Keywords: fettuccine alfredo, healthy fettuccine alfredo, cauliflower recipe, pasta recipe

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Update #1: Many of you have asked about the size of the heads of cauliflower and noted that you’ve had extra sauce. I updated the recipe ingredients to say 3 “small” heads of cauliflower. My produce selection here in the Philippines looks a bit different than the jumbo heads of cauliflower in the states.

Update #2: Here’s a link to my more recent post with just the cauliflower sauce recipe, adapted slightly.

This healthy fettuccine alfredo is made with a creamy cauliflower sauce that tastes just like the real thing. Only 280 calories per serving!

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