The word "chocolate" comes from the Aztecs of Mexico, and is derived from the Nahuatl word xocolatl, which is a combination of the words, xocolli, meaning "bitter", and atl, which is "water". The Aztecs associated chocolate with Xochiquetzal, the goddess of fertility. Chocolate is also associated with the Mayan god of fertility. Mexican philologist Ignacio Davila Garibi, proposed that "Spaniards had coined the word by taking the Maya word chocol and then replacing the Maya term for water, haa, with the Aztec one, atl. However, it is more likely that the Aztecs themselves coined the term, having long adopted into Nahuatl the Mayan word for the "cacao" bean; the Spanish had little contact with the Mayans before Cortés's early reports to the Spanish King of the beverage known as xocolatl.However, professor Michael D. Coe, coauthor of the book The True History of Chocolate, argues that the word xocolatl appears in "no truly early source on the Nahuatl language or on Aztec culture."

Chocolate has been used solely as a drink for nearly all of its history. The earliest record of using chocolate pre-dates the Mayans. Chocolate residue has been found in pottery dating to 1100 BC from Honduras, and 600-400 BC from Belize. The chocolate residue found in an early classic ancient Maya pot in Río Azul, northern Guatemala, suggests that Mayans were drinking chocolate around 400 A.D. In the New World, chocolate was consumed in a bitter, spicy drink called xocoatl, and was often flavored with vanilla, chile pepper, and achiote (known today as annatto). Xocoatl was believed to fight fatigue, a belief that is probably attributable to the theobromine content. Other chocolate drinks combined it with such edibles as maize starch paste (which acts as an emulsifier and thickener), various fruits, and honey. In 1689 noted physician and collector Hans Sloane, developed a milk chocolate drink in Jamaica which was initially used by apothecaries, but later sold by the Cadbury brothers.

Chocolate was also an important luxury good throughout pre-Columbian Mesoamerica, and cacao beans were often used as currency. For example, the Aztecs used a system in which one turkey cost one hundred cacao beans and one avocado was worth three beans