Tenderloin Medallion Pasta Recipe

Prepare and season

Trim any silver skin from the tenderloin and cut into 6 equal medallions (about 1 to 1¼-inch thick). Pat dry with paper towels. Season both sides of each medallion with kosher salt and freshly ground black pepper.

Sear medallions

Heat a large heavy skillet (cast iron preferred) over medium-high heat until hot. Add 2 tbs olive oil and 1 tbs unsalted butter. When the butter stops foaming and the fat shimmers, add the medallions in a single layer without crowding (work in two batches if necessary). Sear 2–3 minutes per side for medium-rare, adjusting time for desired doneness. Use tongs to briefly sear the edge sides if thicker. Transfer seared medallions to a plate and tent loosely with foil to rest while preparing the sauce.

Cook fettuccine

Bring a large pot of water to a rolling boil and add 1 tbs salt. Add fettuccine and cook according to package instructions until al dente. Reserve 1 cup of pasta cooking water, then drain the pasta and set aside. Do not rinse.

Make roux and aromatics

In the same skillet used for the medallions (wipe out excess burned bits but keep browned fond), reduce heat to medium and add 4 tbs unsalted butter. Once melted, add the minced garlic and cook 30–45 seconds until fragrant but not browned. Sprinkle 1 tbs all-purpose flour over the butter and garlic and whisk continuously for 1 minute to cook the flour.

Add milk and cream

Slowly whisk in 1 cup whole milk and 1 cup heavy cream, scraping up any browned bits from the pan. Bring the mixture to a gentle simmer (do not boil) and cook 3–5 minutes, whisking, until slightly thickened.

Finish sauce

Remove the skillet from heat and whisk in 1 cup freshly grated Parmesan cheese until melted and smooth. Season the sauce with 1 tsp salt, ½ tsp freshly ground black pepper, and 1 tsp fresh lemon juice. If the sauce is too thick, whisk in reserved pasta water, 2–4 tablespoons at a time, until you reach a silky coating consistency.

Combine pasta and sauce

Return the skillet to low heat and add the drained fettuccine to the sauce. Toss gently with tongs or two forks to fully coat the pasta, adding more reserved pasta water as needed (up to the reserved 1 cup) to loosen the sauce so it clings to the noodles.

Reheat medallions and plate

If medallions have cooled, nestle them back in the skillet or a warm pan for 30–60 seconds per side to bring them up to serving temperature. Place a portion of sauced fettuccine on each plate (about 6 oz cooked pasta per serving), top with 1–2 beef medallions per plate depending on size.

Garnish

Drizzle 1 tsp extra-virgin olive oil over each plated portion, scatter thinly sliced scallions over the medallions and pasta, and sprinkle chopped parsley if using. Serve immediately.