The authors agree in pointing to a possible Greek etymology for this surname. P. Durante relates it briefly to the Greek kakía, with the sense of "wickedness". V. Blunda develops this hypothesis: it derives from the Greek cacías, "bad person", built on the prefix kako-, "bad", and links it with related surnames such as Cacace and Cacopardo; it would have functioned as a nickname referring to some negative trait of the ancestor, which over time became a family surname.

F. Miranda broadens the picture with other hypotheses. One possibility is the aphaeresis of the term acacia, a plant of the mimosa family. Another points to a nickname linked to the trade of cheese maker, from the Italian cacio, or to the place where the cheese was left to mature. Miranda also gathers, citing D. Macris, the Greek hypothesis of kakiaz (cacías) with a negative moral sense, and adds, drawing on the Vocabolario siciliano of Piccitto, that in the Sicilian dialect càcia or cacía designates a liturgical vestment used in churches during solemnities or processions.

Miranda notes presence of the surname in Calabria, Sicily, Lombardy, Piedmont and Liguria, with concentration in Sicily in the Catania, Messina, Enna, Palermo, Syracuse and Caltanissetta areas.