The surname Visconti and its numerous variants derive from the medieval Latin term vice comes ("viscount"), that is, "the one who acts in place of the count". In medieval Italy, this title designated officials who exercised administrative, judicial or territorial functions in the name of the count, so that the surname has an origin linked to a political or administrative office within the feudal structure.

According to E. De Felice, this type of surname —like others derived from titles such as Conti, Duca, Marchesi or Principe— rarely indicates an effective hereditary nobility. In most cases, these are bynames that alluded to persons who worked for a viscount, lived in his domains or were under his influence. In this sense, the surname reflects a functional or social relationship rather than a real noble title.

Historically, the name is associated with the powerful Visconti family, one of the most influential dynasties of medieval Italy, which governed Milan between 1277 and 1447, first as counts and then as dukes. Its court was famous for its wealth and its political weight, leaving a deep mark on the history of Lombardy. However, the diffusion of the surname is not limited to direct descendants of this family, but spread widely among populations linked to its territories or to its sphere of power.

In fact, already in the 13th century the use of the surname is documented in non-noble contexts. In Monza, for example, individuals such as Vesconti Panizati and Jacobus Vescontus appear in 1237, which shows an early diffusion of the surname among common people, probably tied to Visconti lands or jurisdictions.

The various variants —such as Visconte, Viceconte, Viconti or Vizconti— can be explained by dialectal adaptations, phonetic variations or transcription errors in the historical registers. In other cases, the surname may have a toponymic origin, deriving from localities such as Castelvisconti (Cremona), Grazzano Visconti (Piacenza), Gudo Visconti, Motta Visconti (Milan) or Massino Visconti (Novara), following a common practice in Italy of identifying persons by their place of provenance.

The plural form in -i (as in Visconti or Viceconti) responds to the medieval custom of indicating the family group or lineage, that is, "the descendants of Visconte".

According to E. Rossoni, the surname presents a main nucleus in the north-west of Italy, with a presence also in Lazio, Campania, Apulia and Sicily. Variants such as Viscontini or Viscontino are extremely rare and seem to concentrate in specific areas of northern Italy. In most cases, these surnames indicate a relationship of service or dependence with respect to a viscountal family, and only in exceptional situations may they reflect an effective nobility.

For his part, R. Brondolo defines these surnames as "of political function", linked to those who exercised the role of viscounts, that is, those who governed in place of the counts.