Prep the zucchini: Use a spiralizer, julienne peeler, or buy pre-spiraled zucchini.
Spread the zoodles on a towel, sprinkle lightly with salt, and let sit 10 minutes to draw out excess moisture. Pat dry.
Make the Alfredo base: In a large skillet over medium heat, melt the butter. Add garlic and cook 30–60 seconds until fragrant, not browned.
Add cream: Pour in the heavy cream.
Bring to a gentle simmer and reduce heat to medium-low. Let it bubble softly for 3–4 minutes to thicken slightly.
Enrich the sauce: Stir in the Parmesan a handful at a time until melted and smooth. If using, add cream cheese for extra thickness.
Season with salt, pepper, and a tiny pinch of nutmeg.
Sauté the zoodles: In a separate large skillet, heat olive oil over medium-high. Add the zucchini noodles and toss for 2–3 minutes until just tender but still slightly crisp. Do not overcook.
Combine: Turn the heat off the zoodles.
Pour the Alfredo sauce over them and toss gently to coat. If the sauce looks too thick, add a splash of cream. If it looks thin, let it sit 1 minute to cling.
Finish and serve: Taste and adjust seasoning.
Top with extra Parmesan and chopped parsley or basil. Add cooked chicken or shrimp if you like. Serve immediately.