Heat a large Dutch oven or deep skillet over medium-high heat. Add the ground beef and chopped onion, breaking the beef into small pieces, and cook for 6–8 minutes until no pink remains.

Drain excess fat if necessary, then add the minced garlic. Cook for about 30 seconds, stirring constantly, just until the garlic becomes fragrant.

Stir in the undrained diced tomatoes, tomato sauce, water or beef broth, Worcestershire sauce, Italian seasoning, paprika, salt, and black pepper. Mix well so the seasonings are evenly distributed.

Bring the saucy beef mixture to a boil, then stir in the uncooked elbow macaroni. Make sure the pasta is mostly submerged so it can cook evenly in the tomato broth.

Reduce the heat to medium-low, cover the pot, and simmer for 12–15 minutes. Stir several times while the macaroni cooks, and add a small amount of water if the mixture becomes too thick before the pasta is tender.

Remove the goulash from the heat and let it stand, covered, for 5 minutes. The pasta will continue absorbing the sauce during this rest, so serve as soon as it reaches a tender, saucy consistency.