'pre-pretonic' originates from English, specifically formed by combining the prefix 'pre-' with 'pretonic', where 'pre-' (from Latin 'præ' via Old French) meant 'before' and 'tonic' comes from Greek 'tonos' meaning 'tone' or 'stress'.

'tonic' comes from Greek 'tonos' through Latin/Medieval Latin into English as 'tonic'; 'pretonic' was formed in English by adding the prefix 'pre-' to 'tonic', and 'pre-pretonic' arose by adding another 'pre-' to indicate a position one step further before the tonic.

Initially related to being 'before the tone or stress', the compounded form 'pre-pretonic' has come to mean specifically 'two syllables before the stressed (tonic) syllable' in phonological description.