Bring a large pot of salted water to a boil. Add egg noodles and cook according to package directions until al dente, about 8 minutes. Reserve 1 cup of pasta water, then drain the noodles.

While the noodles cook, melt 2 tablespoons of butter in a large skillet over medium heat. Add sage leaves and cook for 2–3 minutes until fragrant and the edges begin to crisp, stirring gently. Transfer sage to a paper towel.

Add the remaining 2 tablespoons of butter to the same skillet over medium heat. Mince the garlic and add it to the pan, cooking for 1 minute until golden and fragrant.

Add the drained noodles to the skillet with the garlic butter. Toss to coat, adding splashes of reserved pasta water (about 1/4 cup) to create a silky sauce. Cook for 1–2 minutes.

Remove from heat. Stir in 1/2 cup of the Parmesan cheese. Season to taste with salt and pepper. Transfer to bowls and top each serving with crispy sage leaves and remaining Parmesan.