In a large pot, bring salted water to a boil. Add the fettuccine and cook according to package instructions until al dente (usually about 8-10 minutes). Reserve a cup of pasta water before draining.

While the pasta cooks, heat 2 tablespoons of butter in a large skillet over medium-high heat. Season the steak with salt and pepper, then sear for about 3-4 minutes on each side for medium-rare or until desired doneness. Remove the steak and let it rest.

In the same skillet, add the minced garlic and sauté for about 30 seconds until fragrant. Reduce heat to medium-low and pour in the heavy cream, stirring continuously.

Add the cubed Velveeta cheese and remaining butter to the skillet, stirring until melted and creamy. If sauce is too thick, add reserved pasta water a little at a time.

Slice the rested steak into strips. Add the drained pasta and steak slices to the skillet, gently tossing to coat everything in the sauce. Season to taste with additional salt and pepper.

Serve immediately, garnished with freshly cracked pepper or grated Parmesan cheese if desired.