Often sautéed minced meat (and optionally onion) is added, thus creating a lihamakaronilaatikko (literally, meat-macaroni casserole). The Finnish macaroni casserole or makaro(o)nilaatikko is a popular dish made with elbow pasta and egg-and-milk mixture, and baked until it sets. It is sometimes served as a side dish accompanied with stewed meats. Cheddar cheese, a key ingredient in the dish, was brought to Trinidad by English peoples. It has been described as a staple food in Tobago. The dish is very popular in Trinidad and Tobago and is often available as a common dish at lunches and dinners. It is sometimes prepared as a spicy dish, using spices such as black pepper and hot sauces. Macaroni pie is a popular dish in Barbados, where it is commonly consumed as a Main or Side Dish along with fish or meat. In the Caribbean, it is sometimes consumed cold, which may be referred to as "Caribbean style". In the Caribbean, macaroni pie is typically prepared without using a pie crust. Some versions, such as those in Scotland, are prepared using a pie crust, while others are not.
It can be prepared as a low-fat dish using reduced fat cheese and skim milk. Additional ingredients sometimes used include onion and bread crumbs. Typical ingredients in macaroni pie include macaroni pasta, cheese, milk, butter, flour, salt, pepper and various spices.
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