The authors agree that this surname admits several hypotheses of origin. One of the most widespread links it to the Old Italian izzo, a term designating a person of Arab or Saracen origin, or else of dark complexion and hair, with its root in the Latin aegyptius or the Greek aigyptios, meaning "Egyptian".

F. Miranda further records other possibilities: that the surname derives from an aphaeresis of the medieval name Albizzo, an altered form of the Scandinavian name Alberico; or that it comes from the Germanic personal name Hitz or Hilz, built on the root hilde ("struggle, battle"), with the sense of "man of arms, warrior". Miranda also mentions a Sicilian hypothesis relating it to the word izzu, which designated the kite or falcon, but also the child born of a union between slaves.

V. Blunda, focusing on Sicily, specifies that the dialect origin goes back to the word jìzzu, meaning "slave born in the house, domestic servant", and suggests that as a surname it may have arisen as a designation applied to the descendant of a permanent servant in a lordly house.

The surname is found throughout the Italian peninsula, with the greatest concentration in the region of Campania, and an additional presence in Lazio, Lombardy, Piedmont, Tuscany, Emilia-Romagna, Apulia and Liguria. In Sicily it appears scattered across various provinces.