Alfredo is the Spanish and Italian form of Alfred, which comes from the Old English Aelfraed and means "elf counsel", a wise adviser with the elves' gift of insight. Alfred the Great, the ninth-century king of Wessex, made the original famous, and in America the name is also attached to fettuccine Alfredo, created by the Roman restaurateur Alfredo di Lelio. Alfredo ranked number 301 in 2000, peaked at number 298 in 2001 and has drifted down to number 820 in 2025.