1 (8 oz.) box elbow macaroni, cooked, drained
1 1/4 c. tomato soup
1/2 c. water
1/4 c. chopped onions
1/4 c. chopped green pepper
1 tsp. salt
1/8 tsp. pepper
8 links sweet Italian sausage
1/4 c. cubed American cheese

Cook macaroni in boiling salted water until tender. Drain and rinse. Combine the soup, water, chopped onion, green pepper, salt and pepper in a saucepan. Simmer over low heat for 10 minutes.

In the meantime, brown the sausages well on all sides in a skillet. Fold macaroni and cheese into the sauce. Turn into a buttered casserole or baking dish. Arrange sausages down center over the macaroni mixture. Bake in a moderate oven, 350 degrees, until sausages are thoroughly cooked and mixture hot and bubbly, about 45 minutes.