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Peel the brown outer skin off about 3½ ounces of fresh horseradish root using a vegetable peeler, then rinse it thoroughly.
Grate the peeled horseradish finely on the fine side of a box grater, or pulse in a food processor until fluffy but not paste-like.
Transfer the grated horseradish to a small bowl. Add 2 tablespoons white wine vinegar, ¼ teaspoon fine sea salt, and a pinch of granulated sugar. Stir to combine.
Gently fold in 5 fl oz cold heavy cream until the sauce is smooth and creamy.
Taste the sauce and adjust the seasoning with a little more salt or sugar, if needed.
Chill the sauce in the refrigerator for about 30 minutes to let the flavors meld.
Store any leftovers in an airtight container in the refrigerator for up to 1 week.