According to the sources cited below, the surname Pinto derives from a term related to physical appearance, though the scholars differ on the precise meaning. It is considered a nickname-based surname that became established during the medieval period, originating from the adjective dipinto, meaning "painted," already in use as a nickname in the Middle Ages.

V. Blunda offers a more specific interpretation, locating the surname within a Sicilian dialectal context. According to Blunda, it derives from the Sicilian word pìntu, meaning "marked by smallpox," describing skin bearing the circular scars left by that disease. In this reading, the surname would have originated as a physical nickname applied to someone who showed visible traces of the illness, a common condition in earlier centuries. Blunda situates this origin in Sicily.

The two interpretations share a common thread — both point to a visual, descriptive nickname referring to marked or altered skin — but differ in their geographical and semantic focus. The first treats the term in its broader Italian form, while Blunda grounds it specifically in Sicilian dialect and links it to a concrete medical condition.