The authors agree that this surname derives from the place name Mistretta, a locality in the Messina area, in Sicily. E. De Felice notes that it is a diffused and frequent surname in that region.

F. Miranda broadens the origin and specifies that the name of Mistretta has a Semitic root, as a testimony of the Phoenician presence in the locality: the expression Am'Ashtart points back to Astarte, the Phoenician goddess. Tradition attributes the founding of the city to the Sicani, and Greek and Latin sources mention it under forms such as Amestratos, Amestratus, Amastra, Mestraton or Mitistratos. Miranda adds that the surname, although typical of Sicily, is found also in other regions, among them Lombardy, Piedmont, Tuscany, Lazio, Liguria and Emilia-Romagna. Within Sicily it is present in all its provinces, with a particular concentration in the Palermo, Trapani, Agrigento, Caltanissetta, Catania, Messina and Enna areas.