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Gather the ingredients. Preheat the oven to 375 F.
Bring a pot of well-salted water to a boil and cook the elbow macaroni 1 minute less than the directions call for.
Drain the macaroni very well and add to a 9 x 12-inch baking dish.
Stir in the cottage cheese, cheddar cheese, sour cream, milk, Parmesan cheese, salt, and pepper.
In a small bowl, stir the breadcrumbs and melted butter together.
Sprinkle the breadcrumbs evenly over the top of the casserole.
Bake for 35 minutes, or until the top is golden brown and bubbling.