The origin of the term honky-tonk is unknown. The earliest-known use in print is a report in the Fort Worth Daily Gazette, dated January 24, 1889, that a “petition to the council is being circulated for signatures, asking that the Honky Tonk theater on Main Street be reopened.” The fact the words are capitalized suggests it may have been the proper name for the theater; if so, however, it is not known whether the name was taken from a generic use of the word, or whether the name of the theater became a generic term for similar establishments.

There are subsequent citations from 1890 in the Dallas ”Morning News, 1892 in the Galveston Daily News (Galveston, Texas), (which used the term to refer to an adult establishment in Fort Worth), and in 1894 in The Daily Ardmoreite in Oklahoma, in which it was written “honk-a-tonk”. The fact early uses of the term in print mostly appear along a corridor roughly coinciding with cattle drive trails extending from Dallas/Fort Worth, Texas and into South-Central Oklahoma, suggest that the origin of the word may have been a localism spread by cowboys driving cattle to market. The sound of the word “honky tonk” (or “honk-a-tonk”) and the types of places that were called “honky tonks” suggests that the word may be an onomatopoeic reference to the loud or boisterous music and noise heard at a honky tonk.

One theory is the “tonk” portion of the name may have come from a brand name of piano. One American manufacturer of large upright pianos was the firm of William Tonk & Bros.[12][page needed] (established 1881), which made a piano with the decal “Ernest A. Tonk”. These pianos were not manufactured until 1889, contemporaneous to the first occurrences of honky tonk in print, at which point the term seems to have already been established. On the other hand, the Tonk brothers, William and Max, established the Tonk Bros Manufacturing Company in 1873, so such an etymology is possible.

An early source purporting to explain the derivation of the term (spelled “honkatonk”) was an article published in 1900 by the New York Sun and widely reprinted in other newspapers. The article, however, reads more like a humorous urban (or open range) legend or fable, so its veracity may be questionable.