The surname Pesana is a rare Italian surname, scarcely documented as an autonomous entry in the classic onomastic repertoires. Its linguistic structure suggests a northern origin, probably linked to Veneto or Lombardy, where the ending -ana frequently appears in demonym, toponymic or regional derivative surnames.

The etymology admits several hypotheses:

• One of the most probable relates the surname to the place name Pesina, a locality of the comune of Caprino Veronese, in the province of Verona, near Lake Garda. In this case, Pesana would have arisen as a form derived or regionally adapted from that place of origin.
• Another possibility links it to the onomastic group formed by the surnames Pesa, Pesi and Pesaro, derived directly or indirectly from the city of Pesaro, with the form Pesana functioning as a dialectal or regional feminine adaptation.
• A third interpretation connects the surname with the Italian adjective pesante ("heavy"), used as a physical or occupational nickname applied to a corpulent person or one engaged in work of great effort. In this case, the suffix -ana would have contributed to forming a family or demonym designation.

The scant present-day diffusion of the surname seems to confirm its regional and minority character. Among the graphic variants recorded are Pezana, Pezzana and Pessana; the form Pezzana has, in addition, a possible toponymic reinforcement, since there is the comune of Pezzana, in the province of Vercelli, Piedmont, which may have favoured the fixing of that spelling in certain lines.