The surname derives from the given name Mattia, from the Latin Matthias, itself from the Greek Matthias, and this from the Hebrew mattathiah —a variant of mattathai—, whose meaning is "gift of God" (from mattat, "gift", and Ya or Yahweh, "God"). The authors agree that the surname originates in whoever bore that name as the first of the line. Saint Matthias is the apostle who replaced Judas after the death of Christ.

E. De Stefani notes that the alternation between Matteo and Mattia reflects the two traditions through which the same Hebrew name was transmitted. He documents its patronymic use in Carnia —the mountainous area of northern Friuli, in the province of Udine—, where it is recorded from the beginning of the 16th century in the locality of Sutrio. He also mentions a presence in the Pordenone area, at Longarone and in the Cadore.

E. Rossoni, for his part, places the surname mainly in the centre-south of Italy: Lazio, Campania, Basilicata and Puglia, with an additional area in Sicily, in that of Enna.