In a small bowl, whisk together the ketchup, horseradish, Worcestershire sauce, and hot pepper sauce.
Cover and refrigerate until ready to use.
Mix the sauce again before serving.
Serve with poached or boiled shrimp.
Video
Notes
The horseradish I use is quite potent, so I only use one tablespoon. Depending on the brand you use, you might need to add up to two tablespoons. It's best to start with less, then taste and decide.
I don't add a sweetener. However, several readers commented over the years that they added a small amount of sugar-free sweetener, and the sauce tasted exactly like a restaurant one.
You can keep this sauce in an airtight container in the fridge for up to a week. Give it another stir before using it. You can also freeze it for up to three months. I like to freeze it in ice cube trays and then place the frozen cubes in freezer bags.