In a large pot, bring salted water to a boil. Add the fettuccine and cook according to package instructions until al dente. Drain and set aside, reserving about ½ cup of the pasta water.
In a large skillet over medium heat, warm the olive oil. Add the minced garlic and sauté for about 1 minute until fragrant, being careful not to burn it.
Stir in the crushed tomatoes, dried oregano, and red pepper flakes (if using). Simmer for about 5-7 minutes until the sauce thickens slightly.
Lower the heat and pour in the heavy cream, stirring until well combined. Allow it to simmer for another 3-5 minutes, letting the flavors meld.
Stir in the chopped spinach and Parmesan cheese, mixing until the spinach wilts and the cheese is melted. If the sauce is too thick, add some reserved pasta water until you achieve the desired consistency.
Add the cooked fettuccine to the sauce and toss until the pasta is well coated with the creamy mixture. Season with salt and pepper to taste.
Plate the creamy tomato garlic pasta, garnishing with fresh basil leaves and an extra sprinkle of Parmesan cheese if desired.
Notes
Add more red pepper flakes for extra heat if desired.