01 -
Preheat the oven to 350°F.
02 -
Bring a large pot of salted water to a boil and cook the elbow macaroni for 3 minutes less than package directions. Drain thoroughly.
03 -
Heat a large skillet over high heat. Add ground beef and chopped onions, breaking the beef apart. Cook until browned, approximately 6 to 7 minutes, then drain excess fat.
04 -
Add minced garlic to the skillet and cook until fragrant, about 1 minute.
05 -
Stir in Worcestershire sauce, tomato sauce, and diced tomatoes until evenly combined.
06 -
Add Italian seasoning, salt, and freshly ground black pepper. Adjust seasoning to taste.
07 -
Fold in the cooked elbow macaroni and shredded cheddar cheese until thoroughly mixed.
08 -
If the skillet is oven-safe, place it in the oven; otherwise, transfer the mixture to a casserole dish. Bake for 20 to 25 minutes until bubbling and cheese is melted. Serve warm.