The country probably originated as early as the Neolithic period, but its name at that time and in later times is unknown.
In the Etruscan period the village grew flourishing influenced by the town of Veio.
During the Roman rule, those territories became prefecture with the name of "Statonia".
The word "Pitigliano" appeared for the first time in a document of Pope Nicholas II dated 1061 to the ecclesiastics of Sovana, a nearby city that held power in the area until the conquest by the Republic of Siena (Sovana County), and it seems to derive from the Roman family "gens Petilia". Even if the legend leads instead to the fusion of two Roman names: Petilio and Celiano.
After the year one thousand Pitigliano is a fortified village belonging to the Aldobrandeschi family.
In 1274 it was one of the major fortresses that clashed with Orvieto's troops.
The possession of the County of Sovana passed from the Aldobrandeschi to the Orsini family by marriage.
The latter fought first against the Municipality of Orvieto, then with Siena. After the conquest of Sovana by the Sienese in 1410, the capital of the County was moved to Pitigliano.
In 1466 Niccolò III, captain of fortune in the service of the greatest Italian States, came to power: the city lived a phase of splendour thanks to the works of artists and/or architects of the calibre of Baldassarre Peruzzi and Antonio da Sangallo.
At the beginning of the 17th century, Ferdinando I, Grand Duke of Tuscany, bought the Orsini possessions and towards the middle of the century he defended the city from an invasion attempt by the papal troops.
Since then Pitigliano has developed a strong Jewish presence, so much so as to be nicknamed "the Little Jerusalem".