Its preparation and consumption dates back to ancient history, and it originated in the coastal area known as the Maremma, in southern Tuscany and northern Lazio.

Acquacotta is a simple traditional dish originating in the coastal region of Italy known as Maremma,[1] which spans the southern half of Tuscany's coast and runs into northern Lazio.

[5] People that worked away from home for significant periods of time, such as woodcutters and shepherds, would bring bread and other foods with them (such as pancetta and salt cod) to hold them over.

[4][2] In the earlier 1800s, some preparations used agresto, a juice derived from half-ripened grapes, in place of tomatoes,[5] which were not a common food in Italy prior to "the latter decades of the nineteenth century".

[5] Additional ingredients include bread, stock or water, tomato conserva, Parmesan cheese, eggs, mentuccia, wild mint, garlic, olive oil, salt, and pepper.