The surname Paesano is of nickname origin and derives from the term paesano, used to designate a person of the same village or the same community. On this point E. De Felice and V. Blunda agree, noting that it is an appellative applied to distinguish the local inhabitant from the outsider, especially in southern and dialect usage.

V. Blunda further specifies its Sicilian form paisànu, with the sense of "fellow countryman" or "neighbour of the same village", reinforcing its social value within the community. In this way, the surname would have arisen as a nickname identifying the local origin, later becoming established as a hereditary surname.