Begin by placing the guanciale in a large skillet over medium heat. Cook until it is golden and crispy, and the fat has rendered, about 10 minutes.
While the guanciale cooks, bring a large pot of water to a boil. Add a pinch of salt and the pasta, cooking until al dente according to the package instructions.
Reserve 1 cup of the pasta cooking water, then drain the pasta.
Add the freshly ground black pepper to the guanciale and stir to combine.
Pour the reserved pasta water into the skillet with the guanciale, and bring to a simmer.
Add the drained pasta to the skillet. Toss well to coat the pasta in the guanciale fat and allow the sauce to thicken slightly.
Remove from heat and stir in the pecorino romano cheese until melted and the pasta is coated in a creamy sauce.
Adjust seasoning with salt, if necessary, and serve immediately.