Bring a large pot of salted water to a boil. Cook pasta until al dente. Reserve ½ cup pasta water, then drain.
Heat olive oil in a large skillet over medium heat. Add garlic and cook gently until fragrant, about 30–60 seconds.
Stir in crushed tomatoes, salt, pepper, and sugar if using. Simmer for 8–10 minutes until slightly thickened.
Reduce heat to low and slowly stir in the cream until smooth and creamy.
Add cooked pasta and toss to coat. Use reserved pasta water to loosen sauce if needed.
Remove from heat. Taste and adjust seasoning.
Serve warm, topped with Parmesan and fresh herbs if desired.