Step 1

Brown ground beef and diced onions in a large skillet. Drain excess grease if needed and add back to skillet. Season beef with salt and pepper.

Step 2

Add garlic, uncooked elbow macaroni, water, stewed tomatoes, tomato sauce, sugar and Italian seasoning to the skillet with the ground beef. Stir until mixed.

Step 3

Cook over medium low heat at a low simmer until the elbow macaroni is cooked to desired texture, approximately 10 minutes. If the pasta soaks up all the liquid and isn't cooked through, add a little bit more water.

Step 4

Season with salt and pepper to taste. Top with grated Parmesan if desired.