The authors agree that the surname can derive from the dialectal word that designates the ox, or from the place name Bova, a comune of the province of Reggio Calabria. F. Miranda specifies, drawing on several genealogists, that the Greek name of Bova is Boos and its dialectal form Vua, and adds that it could be a Latinised form of the Greek boua ("flock"), of the Greek bous ("ox"), or —according to Mosino— of the medieval Greek boua meaning "grain pit".

E. Rossoni incorporates two additional hypotheses: a derivation from the noble Albanian surname Bua, whose bearers held the title of Barons of Morea in the 15th century, and another from the Bosnian surname Buha, whose bearers emigrated towards Dalmatia and other areas of Italy after the Turkish invasion of that same century. Rossoni also documents the transformation into a surname in Carolei in 1612.

As for its geographical distribution, the authors agree that the areas of greatest presence are Sicily and Sardinia. Miranda details within Sicily clusters in the provinces of Palermo, Catania, Trapani, Messina, Agrigento and Enna. Rossoni also notes presence in Calabria and in southern Lazio, and mentions the variant Buo, very rare, with specific areas in Naples and Foggia.