Pastitsio takes its name from the Italianpasticcio, a large family of baked savory pies which may be based on meat, fish, or pasta. Many Italian versions include a pastry crust, some include béchamel. The word pasticcio comes from the vulgar Latin word pastīcium derived from pasta, and means "pie", and has developed the figurative meanings of "a mess", "a tough situation", or a pastiche.
The typical Greek version has a bottom layer that is bucatini or other tubular pasta, with cheese and egg as a binder; a middle layer of ground beef, veal or lamb with tomato and cinnamon, nutmeg or allspice; another layer of pasta; and a top layer of sauce, varying from an egg-based custard to a flour-based Béchamel or a Béchamel with cheese (known as Mornay sauce in France). Grated cheese is often sprinkled on top. Pastitsio is a common dish, and is often served as a main course, with a salad.
In Cyprus a similar dish is called "oven macaroni" (Greek: μακαρόνια του φούρνου, makarónia tou foúrnou; Turkish: fırında makarna). It is an essential dish during celebrations such as Easter, where it is served along with the spit roasted meat. Recipes vary, but usually the meat sauce in the middle is made of pork, tomatoes are only sometimes used, and it is flavored with mint and parsley. The top is sprinkled with grated halloumi cheese, though cheese is only sometimes added to the white sauce.
A slice of Egyptian Macaroni Béchamel
Macaroni Béchamel (Arabic: المكرونة البشاميل, al-makarūnah al-bashāmīl) is the Egyptian version. It is typically made with penne pasta, a layer of cooked spiced meat with onions, and Béchamel or Mornay sauce.
In Malta, Timpana (the name probably derived from Timballo) is made by tossing parboiled macaroni in a tomato sauce containing a small amount of minced beef or corned beef, bound with a mix of raw egg and grated cheese. Hard-boiled eggs are sometimes added. The macaroni is then enclosed in pastry case or lid before being baked.