The authors agree that this surname is of Sicilian origin and derives from the dialectal term stisi, which designates something "lying down, stretched or elongated". V. Blunda specifies that it is a plural participle and proposes that, as a surname, it could have originated in a nickname applied to a person of notoriously tall stature or known for their fondness for rest.

F. Miranda broadens the etymological analysis by also noting the form stissi, plural of stissu, meaning "the same, identical", and further gathers the hypothesis of the scholar Caracausi, according to which the surname could derive from the Greek stheti, "heart", although this interpretation is presented as secondary and not generalized.

As for its geographical distribution, the surname is concentrated predominantly in Sicily, where it is documented in the Catania, Enna —in particular in the municipalities of Enna, Regalbuto and Nicosia— and Ragusa areas. Miranda notes in addition a very occasional presence in other regions of the north and centre of Italy, such as Lombardy, Piedmont, Veneto, Liguria, Tuscany, Molise and Lazio.