Bring a large pot of salted water to a boil. Cook the fettuccine according to package directions until al dente. Drain, but reserve 1 cup of the pasta water.

Heat a large skillet over medium heat. Add the lean ground beef and brown it, breaking it into small pieces with a spatula. Season with salt and pepper. Cook until no pink remains, about 5–7 minutes.

Push the cooked beef to one side of the skillet. Add the minced garlic to the empty side and sauté for about 1 minute, until fragrant.

Pour in the heavy cream and reduce heat slightly. Gradually stir in the Parmesan, whisking or stirring continuously until the sauce becomes smooth and creamy.

Stir in the fresh spinach and Italian seasoning. Let the spinach wilt into the sauce, scraping up any browned bits from the skillet for extra flavor.

Add the drained fettuccine to the skillet and toss to combine. If the sauce seems too thick, add reserved pasta water a little at a time until you reach the desired consistency. Taste and adjust seasoning.

Serve hot, optionally with an extra dusting of grated Parmesan and cracked black pepper.