Boil water and salt in a large pot. When the water has a rolling boil, add the pasta. Cook until al dente, at a high flame, for about 10-15 minutes. The pasta will be cooking while you cook the sauce.
Dice onion and garlic.
In a separate pan with a medium high flame, add oil or butter, onion, and garlic and mix until fragrant.
Add vodka and mix it in with the tomato paste. Once the alcohol has reduced, add the balsamic vinegar. Stir it in until it fully combined and has a deep red color.
Add heavy whipping cream and one spoon of pasta water. mix it until it is all blended and creamy.
Add the cooked pasta, red chili flakes (optional), and grated parmesan cheese.
Plate and enjoy, be sure to add more parmesan cheese if you want it to be cheesier.