Alfredo sauce comes from the classic Italian dish, Fettuccine Alfredo. The dish was invented by Alfredo di Lelio, at his restaurant Alfredo alla Scrofa in 1914 and is a variation on fettuccine al burro. It is made from Parmesan cheese, butter, and heavy cream and sometimes a tiny pinch of nutmeg and black pepper. While commercial versions are available, making it at home from the best quality ingredients will yield the most luxurious sauce.