Bring a large pot of salted water to a boil. Cook pasta according to package directions until al dente. Reserve 1 cup of pasta water before draining.

While pasta cooks, melt butter in a large skillet over medium heat. Add minced garlic and cook for 30 seconds until fragrant.

Pour in heavy cream and bring to a gentle simmer. Let it bubble for 2-3 minutes to thicken slightly.

Reduce heat to low and add crumbled gorgonzola. Stir constantly until cheese melts into a smooth sauce.

Add drained pasta to the sauce and toss to coat. Add reserved pasta water a few tablespoons at a time if sauce is too thick.

Season with salt and freshly cracked black pepper to taste. Serve immediately, garnished with fresh sage leaves if desired.