Bring a large pot of salted water to a rolling boil over high heat. Add your choice of penne or rotini pasta and cook according to package instructions until al dente, about 8-10 minutes. Drain and set aside.

In a large skillet, heat olive oil over medium heat. Add the diced onions and minced garlic, sautéing for 3-4 minutes until the onions are translucent and fragrant.

Add the ground beef, breaking it apart with a wooden spoon. Cook for 5-7 minutes until browned and cooked through. Drain excess fat.

Pour in the Rotel tomatoes, including the juices, followed by the cream of mushroom soup. Stir well and let bubble gently for about 2 minutes.

Lower the heat to medium-low and gradually stir in heavy cream. Simmer for 5 minutes, stirring occasionally until slightly thickened.

Sprinkle in shredded cheddar cheese, stirring until completely melted and smooth.

Taste and add salt and pepper as needed. Fold in the drained pasta, tossing gently to coat with the sauce.

Remove from heat and serve hot, garnished with chopped green onions if desired.