While many major cultures have their own version of meatball, this dish is still believed to be traditionally Italian. Spaghetti was one of the only Italian ingredients available in the United States at the time, so people started eating pasta and meatballs together. Italian-American food became more prominent over time and, today, is one of the most popular dishes in the country. In the late 19th and early 20th centuries, Americans ate a lot of red meat, and meatballs were an affordable and easy to prepare recipe.
American meatballs are the largest in size, with Italian and Swedish meatballs following the depth chart.