According to E. De Felice, E. Rossoni, F. De Laurentiis, and B. Zuanella, the surname Bevilacqua derives from the medieval nickname Bevilacqua, literally meaning “drink the water.” However, the expression was not intended literally. The authors explain that it was an ironic or jocular nickname, commonly given to someone known for drinking wine rather than water, a type of humorous inversion that was widespread during the Middle Ages.

B. Zuanella notes that the nickname is documented as early as the 11th century in Latinized forms such as Petrus bibens aquam (1037) and Gregorius qui dicitur bibit aquam (1050–1056), demonstrating its early use as a personal name before becoming a hereditary surname.

The same authors also acknowledge a possible toponymic origin in some cases, deriving from places named Bevilacqua, particularly in the areas of Verona, Bologna, and Ferrara. In these instances, the surname would indicate geographical origin rather than a nickname.

According to B. Zuanella, the surname Bevilacqua is widespread throughout Italy, especially in northern regions and the Neapolitan area. Taken together, the evidence suggests a surname of dual origin, predominantly derived from an ironic medieval nickname and, in some cases, from Italian place names bearing the same name.