The authors agree that this surname is of Sicilian origin and propose two main etymologies. The first links it to the Sicilian dialectal term cucuzza (in the also recorded form cocuzza), which designates the pumpkin and comes from the Late Latin cucutia; it would have functioned as a nickname alluding to physical traits, such as the elongated shape of the head, or to characteristics of behaviour. The second connects it with the Greek kokkuzo, with the sense of "to sing like a rooster".

F. Miranda adds that, although the surname is essentially Sicilian, it is also spread in Lombardy, Lazio, Piedmont, Liguria, Tuscany, Veneto and Emilia-Romagna. Within Sicily it appears in all the provinces, with greater presence in the Catania area, in the Enna area —in localities such as Gagliano Castelferrato, Leonforte, Centuripe and others— and in the Ragusa and Messina areas. Miranda also gathers the opinion of the scholar Galluppi, who maintains that the surname would be native to Spain.

E. Rossoni, for his part, notes that the Greek derivation would correspond to the oldest forms of the surname.