In a medium bowl, combine mayonnaise and ketchup until smooth.
Stir in prepared horseradish, fresh lemon juice, and Worcestershire sauce.
Add Old Bay seasoning, garlic powder, black pepper, and hot sauce if using. Mix well.
Taste and adjust seasoning, adding more Old Bay or horseradish for an extra kick.
Chill in the refrigerator for at least 30 minutes to let flavors meld.
Serve as a zesty dip for shrimp, crab, oysters, or your favorite seafood.