Cook pasta in large pot of boiling, salted water.
Meanwhile, in medium frying pan over low heat, add pesto and garlic. Heat and stir.
Add cream, bring to simmer.
Once pasta is cooked, scoop out 1/3 cup of the pasta water (before draining) and add directly to the sauce. Drain pasta.
Toss noodles with sauce, stirring to coat. Season with salt and pepper. Serve sprinkled with parmesan.