In a large saucepan or cast iron skillet over medium-high heat, cook the ground beef and diced onion until the beef is browned, about 5-7 minutes. Drain any excess grease.
Add the diced tomatoes, Italian seasoning, salt, pepper, water, and half and half to the skillet. Stir in the elbow macaroni. Bring to a boil, cover, and reduce heat to simmer for 14-18 minutes until the pasta is tender. Stir occasionally.
Remove the lid and take the pan off the heat.
Stir in the cheddar cheese and let the residual heat melt the cheese, creating a creamy texture.
Serve warm and enjoy!
Notes
Be sure to drain excess grease after cooking the ground beef. Stir occasionally while cooking the pasta to prevent sticking.