Cheese and pasta casseroles were recorded in the 14th century in the Italian cookbook Liber de Coquina, which featured a dish of Parmesan cheese and pasta. A cheese and pasta casserole known as makerouns, was recorded in the 14th-century medieval English cookbook the Forme of Cury.[7] It was made with fresh, hand-cut pasta which was sandwiched between a mixture of melted butter and cheese. The recipe given (in Middle English) was:

Take and make a thynne foyle of dowh. and kerve it on pieces, and cast hem on boiling water & seeþ it well. take cheese and grate it and butter cast bynethen and above as losyns. and serue forth.

The first modern recipe for macaroni and cheese was included in Elizabeth Raffald's 1769 book, The Experienced English Housekeeper. Raffald's recipe is for a Béchamel sauce with cheddar cheese—a Mornay sauce in French cooking—which is mixed with macaroni, sprinkled with Parmesan, and baked until bubbly and golden.[1]

Another recipe from 1784 stated that the small tubes of macaroni must be boiled, then drained in a sifter before being moved to a frying pan. Heavy cream is then added to the macaroni along with a "knob of butter" rolled in flour, and it must be cooked for five minutes before being transferred to a dish and topped with toasted Parmesan and pepper.[9] Eliza Acton's Modern Cookery in All Its Branches (1845) has a similar recipe for macaroni and cheese, called "Macaroni a la Reine".

The US president Thomas Jefferson encountered macaroni in Paris and brought the recipe back to Monticello. James Hemings, a classically trained French chef enslaved by Jefferson, was also instrumental in bringing the recipe to the United States.[13]