Bring a large pot of salted water to a boil. Add the elbow macaroni and cook according to package instructions until al dente.

Drain the macaroni in a colander and set aside.

In a skillet, heat olive oil over medium heat. Add the chopped onion and garlic, sautéing until the onion is translucent.

Add the chopped tomatoes, salt, and pepper. Cook for about 10 minutes, stirring occasionally, until the tomatoes are softened.

Add the cooked macaroni to the skillet with the tomato mixture. Stir well to combine and heat through.

Serve hot, topped with grated cheese if desired.