 Cincinnati chili ( or Cincinnati @-@ style chili ) is a Mediterranean @-@ spiced meat sauce used as a topping for spaghetti ( a " two @-@ way " ) or hot dogs ( " coneys " ) , both dishes developed by Macedonian immigrant restaurateurs in the 1920s . Ingredients include ground beef , stock , tomato paste , cinnamon , other Mediterranean spices and sometimes chocolate in a soup @-@ like consistency . Other toppings include cheese , onions , and beans ; specific combinations of toppings are known as " ways " . The name " Cincinnati chili " is often confusing to those unfamiliar with it , who expect the dish to be similar to chili con carne ; as a result , it is common for those encountering it for the first time to conclude it is a poor example of chili . 
