Cook pasta according to package directions. Reserve 1 cup pasta water before draining.
While pasta cooks, season shrimp with salt and pepper.
Melt butter in a large skillet over medium-high heat. Add shrimp and cook 2-3 minutes per side until pink. Remove and set aside.
In the same skillet, add garlic and cook for 1 minute until fragrant.
Add white wine and let simmer for 2 minutes.
Stir in heavy cream and bring to a gentle simmer.
Add cooked pasta, shrimp, and Parmesan. Toss to combine. Add pasta water if needed to loosen the sauce.
Season with salt, pepper, and red pepper flakes if using.
Garnish with fresh parsley and serve immediately.