Healthy Fettuccine Alfredo Recipe - Skillful Cook
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Healthy Fettuccine Alfredo

98 reviews / 4.6 average

I've been making a mess lately.

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.
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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

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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  1. Skillful Cook Logo

    I’m home sick from work today and all I can think about is how a giant bowl of this pasta would make me feel so much better. Plus with all that cauliflower in there, I’m sure it’s practically medicinal.

    1. Skillful Cook Logo

      Will definitely try a version of this. Not so much because it’s healthier than alfredo but because I super really love cauliflower, and because my boyfriend really does not, I never end up buying it (half usually goes to waste before I can eat it all). Think this would make it easy to eat it quicker.

  2. Skillful Cook Logo

    Lindsay. we are twinsies. i made cauliflower alfredo last weekend!!! of course, yours look so much better. but really – can you go wrong with alfredo? especially of the healthy variety? love the pretty colorful boxes w/ the nutritional info on there – so crazy how much better this is for you than your typical restaurant version!

  3. Skillful Cook Logo

    A few months ago, I would’ve looked at this and laughed. Cauliflower? ha. But I just started pureeing it with coconut milk and garlic at every chance I get for a mashed potato alternative and now I believe in it’s powers. This looks unreal! 🙂

  4. Skillful Cook Logo

    Oh my goodness, this looks so incredible!! Now I feel like I need to find those sweet potato noodles. Obviously, I will need to make a batch sans sweet potato pasta to hold me over. I have a recipe for what I call “sneaky” Mac and Cheese that uses cauliflower and butternut squash, and it is like my favorite!! This one is totally going to be my new favorite!! 🙂

    1. Skillful Cook Logo

      Alyssa, where did you find that recipe for the stealthy (healthy) Mac and cheese? It’s a favorite of my husbands but I hate the butter/cream calorie punch it packs (not to mention the lbs it packs) if I make it as often as he likes! (Every other night practically.) if you were willing to share your ninja-recipie I would SOOO appreciate it!

      1. Skillful Cook Logo

        Also, I’m sorry for mis-spelling your name 🙁 typing on an iPhone here and couldn’t see the right spelling as I was typing. But gosh I hate doing that to people!

          1. Skillful Cook Logo

            We wouldn’t recommend freezing leftovers because the noodles may get mushy.

  5. Skillful Cook Logo

    You’re my hero. SERIOUSLY. Skinny Alfredo is a dream come true. THANKS!! 🙂

  6. Skillful Cook Logo

    Looks delicious! I would never have thought of using cauliflower in a sauce! I still have to make your cauliflower pizza dough too.

  7. Skillful Cook Logo

    Your fettucine looks amazing and the way you describe the noodles has me super intrigued!! Where did your mom get the noodles? As a huge fan of sweet potato, I’d love to try them and the fact that they have warm seasoning makes them sound so appealing! I’d definitely slurp this fettucine down and get cream sauce all over the place!

    1. Skillful Cook Logo

      You totally could. My husband is an alfredo snob. I made this tonight, and he said if he hadn’t have seen me pureeing the cauliflower, he wouldn’t have believed it. It’s fantastic! I am a total foodie, and can usually notice when things are remade as healthy, especially if a recipe is heavy on cream/butter/cheese, because it’s so hard to replicate those tastes and delicious mouth feel. But this one does it! I hope you and your husband enjoy it as much as we did!

      1. Skillful Cook Logo

        Hi, Kristin! (great name, by the way 🙂 ) In general, we don’t recommend freezing dishes with pasta in them as the noodles can get mushy. However, this creamy cauliflower sauce could certainly be made ahead of time and/or frozen! For the noodles I would cook them closer to when you’re going to eat them, but they could be tossed with the previously made sauce. Hope that helps!

  8. Skillful Cook Logo

    Will definitely try a version of this. Not so much because it’s healthier than alfredo but because I super really love cauliflower, and because my boyfriend really does not, I never end up buying it (half usually goes to waste before I can eat it all). Think this would make it easy to eat it quicker. 🙂

  9. Skillful Cook Logo

    Wow that is a brilliant recipe…i did see the sweet potato past noodles in the grocery store and keep forgetting to buy pasta, dont love the effects of it!

  10. Skillful Cook Logo

    This looks incredible. I can’t wait to try it and love that it is made with cauliflower. What a good idea!

  11. Skillful Cook Logo

    Oh! I love that this is a healthy alfredo. I never eat alfredo b/c I feel that it’s so unhealthy. I recently tried a potato soup recipe that has some cauliflower in it and loved it so I suspect I would love this one too! Pinning for later–can’t wait.

  12. Skillful Cook Logo

    So. I’m cool with the cauliflower. I get down with veggies. But if we can be honest here, I don’t believe you that this tastes like Alfredo because it’s missing the best part. The cheese. I need someone to attest to a cheese factor here. 🙂

    1. Skillful Cook Logo

      Good point – I did add a little Parmesan cheese to this the second time I made it but I actually liked it better without! Weird.

    2. Skillful Cook Logo

      Agree w/ Christina. Made this tonight. I could skip the olive oil and with 1/2 c. grated parm I was a happy camper. It’ll still be lower fat than traditional alfredo. Either way, this is way more successful for me than a mac and cheese recipe I made w/ cauliflower.

  13. Skillful Cook Logo

    Wowser!!! This is awesome!! I’m really into veggies turned sauces… it works so well with sweet potatoes and butternut squash and asparagus and peas… why did I never think of this?! You are an alfredo genius.

  14. Skillful Cook Logo

    Welllll, hello there, beautiful Alfredo! I feel a little embarrassed that this is my first visit to your blog. Confession: I found you by searching for “cream cheese coffee cake.” But I stayed because I wanted to eat the Alfredo. And like you, I need lightness, noodles with illusions. Thanks for this recipe. You have a new fan. Gorgeous, gorgeous blog. So simple, so splendid. Cheers.