[1] Originally inspired by similar dishes from southern Italy, the modern version of spaghetti and meatballs was developed by Italian immigrants in New York City.

It grew in popularity during the first half of the 20th century and is today considered a classic in Italian-American cuisine both in New York City and the rest of the U.S.[2] When arriving in America, Italian immigrants brought their food traditions with them, but the availability of new ingredients and a better economy meant that traditional peasant foods from southern Italy evolved.

This often included the addition of more expensive ingredients and a higher meat content, creating more plentiful meals.

[3] Early references to the dish include: By mid-century spaghetti and meatballs was firmly locked in American food tradition and popular over most of the country.

Italian writers and chefs often mock the dish, together with many other popular examples of Italian-American cuisine such as chicken parmesan and Caesar salad, as pseudo-Italian or non-Italian.