Preheat oven to 350 degrees.
Bring a large pot of water to boil. Cook macaroni for 3 minutes less than the box directions, then drain.
Heat a large skillet over high heat. Add ground beef and onions to the pan. Break beef apart, cooking for 6-7 minutes until browned. Drain any fat.
Mix in garlic and cook until fragrant, about 1 minute.
Add in Worcestershire sauce, tomato sauce, and diced tomatoes. Mix until combined.
Stir in the Italian seasoning, salt, and pepper. Taste and adjust the seasonings.
Mix in cooked macaroni and cheddar cheese. If your skillet is heat-safe, you can place in the oven for 20-25 minutes until the goulash is bubbly and the cheese is melted. If the skillet is not heat-safe, transfer the goulash to a casserole dish and bake.
Enjoy