The authors agree that this surname is characteristic of Sicily and derives from Greek with the meaning of "worthy" or "deserving". F. Miranda specifies that it is a very rare surname, typical of the Catania area —with presence in Fiumefreddo di Sicilia and Paternò—, with clusters also in the Syracuse area and in that of Enna, specifically in Catenanuova. Outside the island, Miranda records its presence in Piedmont and in Veneto. As for the origin, he proposes that the surname probably derives from the medieval Latin name Axia, taken from the Greek axia.

V. Blunda notes that the reference Greek form is Acsìa, and adds a functional interpretation: the term would have initially operated as a nickname applied to a female ancestor for her uprightness or honour, or as a personal name of positive connotation, which later became a surname along the family line.