F. Miranda notes that this surname is of Sicilian origin and derives from the dialectal word bisicchia, which in Sicilian designates a piece of land ploughed for the third time. He also points out that, in early 20th-century Sicily, the term came to be used also to refer to a very thin person, "skin and bone", while bisicchiato described someone gaunt and thin. From that use, Miranda proposes that the surname arose as a nickname attributed to a founding ancestor with those physical characteristics.

V. Blunda, on the other hand, classifies it within the group of rural toponymic surnames and derives it from the dialectal word bbisìcchia, meaning "alluvial land". According to this interpretation, the surname could have originated in a microtoponym applied to someone who lived or worked on plots formed by soil displacements on unstable slopes, frequent in the rugged landscape of the Sicilian interior.

Both etymologies start from the same Sicilian dialectal term, but diverge in their meaning: Miranda favours the figurative use referring to a thin person, while Blunda recovers the geological-territorial meaning. The distribution of the surname is concentrated mainly in Sicily, with presence in the Catania, Syracuse, Messina and Trapani areas, as well as localities such as Aidone and Regalbuto in the Enna area.