The name Tepetlaoxtoc comes from Náhuatl and means in limestone caves, and is used interchangeably to refer to the town, the municipality and the archeological ruins.

Tepetlaoxtoc, along with these towns was invaded by the Chichimeca chief Xólotl, whose son Nopaltzin discovered the ruins of the ancient Teotihuacán-era city.

Don Diego ruled over 70 years but left no heirs so this arrangement ended in 1593 when the government passed into the hands of Luis de Tejada.

[1] The friar Domingo de Betanzos chose Tepetlaoxtoc to found a hermitage, small cloister and chapel between 1527 and 1528, which the Indians called Tlaxcantla.

The highest elevations are (in meter above sea level) Huilotepec (3,550m), Tlamacas (3,340), Montecillo-el Organo (3,100), Huilo Chico (3090), and Tepeyahualco (3000).

[1] 90% of the municipality's economy is still agricultural, with many rural people living on ejidos and taking secondary work in addition.