The authors agree that this surname derives mainly from the numerous Italian place names bearing that name. Among the most cited are Monteleone di Puglia, Monteleone di Calabria —corresponding to present-day Vibo Valentia— and, according to F. Miranda, also Monteleone di Spoleto, in the Perugia area. E. Rossoni notes that Monteleone di Calabria was one of the two capitals of Calabria in the 19th century and is celebrated for its castle.

Rossoni identifies the areas of greatest presence in southern Calabria, in the Taranto area, in those of Naples and Salerno, and in Sicily. Miranda broadens this picture and indicates that the surname is spread across all the regions of Italy, with the greatest concentration in Sicily —where it is present in all its provinces, with a predominance in Palermo, Trapani, Agrigento, Catania and Messina—, followed by Calabria, Puglia, Piedmont, Lombardy, Lazio, Campania, Liguria, Emilia-Romagna, Tuscany and Basilicata.

Miranda adds an alternative hypothesis: the surname could come from a nickname applied to people originating in mountainous areas. Rossoni further mentions the variant Montelione, very infrequent and located between the Palermo and Agrigento areas.