The authors agree that this is a surname of Sicilian origin, derived from a nickname. The two most proposed etymologies are the Greek term πίπτω (pipto), which means 'to fall', and the Sicilian dialect word pipituni, which designates the hoopoe, a bird with a showy crest and a characteristic song.

V. Blunda notes that, as a nickname, it could have been applied to a person with striking hair or a peculiar voice comparable to the call of the bird, in keeping with its presence in Sicilian popular tradition. F. Miranda adds, drawing on Piccitto, that pipituni also designates a heap of stones gathered from cultivated fields and piled up loose.

E. Rossoni specifies that the surname is documented from 1309 in Carini, in the Palermo area, and from 1512 in the Trapani area. Its main distribution is concentrated in that last area —especially in Marsala, but also in Alcamo, Petrosino, Mazara del Vallo, Trapani, Castellammare del Golfo, Erice, Salemi and Castelvetrano— and in the Palermo area, particularly in Altofonte, Torretta and Misilmeri. Miranda broadens the geographic distribution and indicates a presence in other areas of Sicily: the Agrigento area (Sciacca, Montevago, Menfi), the Messina area (Messina, Torregrotta), the Catania area (Catania, Acireale), the Syracuse area and the Enna area (Regalbuto). Outside Sicily, the surname appears secondarily in Lombardy, Lazio, Piedmont, Emilia-Romagna, Liguria and Veneto. Rossoni considers the variant Pipitoni practically unique and probably the result of a transcription error.