Bring a large pot of salted water to a boil for the pasta—this takes time, so start it first. While waiting, prepare all your ingredients: cut the chicken into 1-inch bite-sized pieces, slice the red pepper into 1/4-inch strips, mince the garlic, measure out the carrots, and chop the cilantro. Having everything prepped and ready will make the cooking process smooth and prevent any rushed moments.
In a medium bowl, whisk together the salsa, creamy peanut butter, lime juice, honey, soy sauce, and freshly grated ginger until smooth and well combined. The sauce should have a rich, slightly thick consistency with no lumps of peanut butter. Set aside—this sauce is the flavor foundation of the entire dish.
Once the salted water is at a rolling boil, add the fettuccine and cook according to package directions until al dente (usually 8-10 minutes). While the pasta cooks, heat 1 tablespoon of olive oil in a large skillet over medium-high heat. Once the oil is hot and shimmering, add the prepared chicken pieces in a single layer and cook for 5-8 minutes, stirring occasionally, until the chicken is golden brown and cooked through.
To the skillet with the cooked chicken, add the minced garlic and cook for about 30 seconds until fragrant. Then add the sliced red pepper and shredded carrots, stirring frequently. Cook for 3-4 minutes until the vegetables are tender but still have a slight bite—I prefer not to overcook them so they maintain their bright color and texture contrast with the sauce.
Pour the Thai peanut sauce from Step 2 over the cooked chicken and vegetables in the skillet. Stir well to coat everything evenly, and heat through over medium heat for about 1-2 minutes. The sauce will coat all the ingredients beautifully and create a cohesive, flavorful mixture.
Drain the cooked fettuccine from Step 3, reserving about 1/4 cup of pasta water. Add the drained pasta to the skillet with the chicken-sauce mixture and toss everything together until the pasta is evenly coated. If the sauce seems too thick, add a splash of reserved pasta water to loosen it slightly and create a silky consistency.
Divide the Thai chicken fettuccine among serving bowls or plates. Top each portion generously with the fresh chopped cilantro and crushed peanuts—I always add the peanuts right before serving so they stay crunchy rather than getting soggy from the sauce. Serve immediately while everything is hot and the flavors are bright.