Turning your stovetop to medium heat, in a saucepot, add in your butter and minced garlic abd whisk to combine.
Once your garlic is now cooked and fragrant add in your sage and seasonings. Let cook for a minute.
Slowly add and whisk together the heavy cream, whole milk and pumpkin puree. Let sauce begin to boil and thickness then reduce heat to low and allow it to simmer for about 2-3 minutes.
Lastly, add in the parmesan cheese and whisk together. OPTIONAL: if you'd like the sauce to be a lot thicker especially if you're using dairy alternatives, you can add in a 1/2 tablespoon of pasta water and flour, mix together and add intothe sauce. Once sauce is at your desired consistency, add in your cooked pasta and 1/4 cup of pasta water and toss the pasta in the sauce.
Garnish with fresh sage leaves, plate, serve and enjoy!