In a large pot or Dutch oven, brown the ground beef over medium-high heat. Drain any excess grease.
Add the chopped onion to the pot and cook until softened, about 5 minutes.
Stir in the diced tomatoes, tomato sauce, Worcestershire sauce, Italian seasoning, salt, and pepper. Bring to a simmer.
Add the uncooked elbow macaroni to the pot. Stir well to combine.
Reduce heat to low, cover, and simmer for 20-25 minutes, or until the macaroni is tender and the sauce has thickened, stirring occasionally to prevent sticking.
Serve hot and enjoy!
Notes
Optional: Top with shredded cheese before serving for an extra cheesy delight.