Bring a large pot of salted water to a boil. Add your pasta of choice—spaghetti or fettuccine—and cook according to package instructions until al dente. Reserve about 1/2 cup of pasta water before draining.
While the pasta cooks, heat 2 tablespoons of olive oil in a large skillet over medium-high heat. Add the shrimp in a single layer and season with salt, pepper, and a pinch of red pepper flakes if using. Cook for about 2 minutes per side or until the shrimp turn pink and opaque. Remove shrimp from the skillet and set aside.
In the same skillet, add minced garlic and sauté for about 30 seconds until fragrant but not browned. Pour in the crushed tomatoes, stirring to combine. Let the sauce simmer for 5-7 minutes to thicken slightly and deepen in flavor.
Reduce the heat to low, then stir in the heavy cream and grated Parmesan cheese. Mix well until the sauce is creamy and smooth. If the sauce seems too thick, add a splash of the reserved pasta water to loosen it up.
Return the cooked shrimp to the skillet along with the drained pasta. Toss everything gently to coat the pasta and shrimp evenly in the sauce. Stir in the fresh chopped basil and adjust seasoning with salt and pepper to taste.
Plate the pasta and garnish with extra basil or Parmesan if desired. Serve immediately and enjoy.