The consulted works concur in tracing this surname to the place name Nicosia, a town in Sicily. E. De Felice characterizes it as a Sicilian surname and notes a particular presence in the areas of Messina and Catania. E. Rossoni adds a geographic precision, specifying that the Nicosia in question is located in the area of Enna. The source Surnames in Italy similarly records the derivation from the Sicilian town of Nicosia.

F. Miranda broadens the etymological analysis of the place name itself. According to one interpretation, the toponym derives from the Greek Nikòi Oikòs, with the meaning of "city of San Nicola"; according to another, it comes from Nikes Oikòs, which would mean "city of victory." Miranda further notes that while the surname is most deeply rooted in Sicily, where it appears across all provinces, it has also spread to other regions of Italy, including Lombardy, Lazio, Piedmont, Tuscany, and Emilia-Romagna.