The authors agree that the surname derives from the personal name Damianus / Damianos, of Greek origin. On its meaning, however, the sources present nuances. F. Miranda notes that the Greek Damianos (Δαμίανος) was linked to the cult of Damia-Cybele, goddess of the earth and of fertility, and that the name meant "subject to Damia". S. Vannozzi and V. Blunda agree that the etymon refers to the Greek verb damao, "to tame", with the sense of "tamer"; Vannozzi also adds the sense "descendant of Damia", identifying this Greek divinity with Demeter or Cybele.

Blunda highlights that the diffusion of the name as a surname is linked to the Byzantine hagiographic tradition, concretely to the figure of Saint Damian, whose cult functioned as a vehicle for the transmission of the baptismal name, in a way analogous to what happened with the surname Cosma.

As for the geographical distribution, Miranda indicates that the surname is present in around seven hundred comuni of all the Italian regions, with greater concentration in the south: Campania, Sicily, Puglia and Basilicata, although it is also documented in Piedmont, Lombardy, Lazio, Liguria and Tuscany. In Sicily it appears in all the provinces, with prominent presence in the Palermo, Messina, Trapani, Agrigento and Catania areas. Vannozzi, for his part, characterises it as a surname of pan-Italian reach with prevalence in the centre-south of Italy.