Boil a large pot of salted water and cook pasta according to package instructions until al dente, about 8-10 minutes. Drain and reserve a cup of pasta water.

In a skillet, heat olive oil over medium heat. Add minced garlic and sauté for 1-2 minutes until fragrant.

Lower the heat and stir in pumpkin puree and heavy cream. Cook for 3-4 minutes until well combined.

Add Parmesan cheese and nutmeg. Stir for 2-3 minutes until cheese melts. Add reserved pasta water if too thick.

Add the drained pasta to the skillet and toss for 2-3 minutes to coat in sauce.

In a separate pan, cook prosciutto until crispy, about 3-4 minutes each side. Drain on paper towels.

Serve pasta in bowls topped with crispy prosciutto and extra Parmesan cheese.