The word Cēmpoalli comes from the Nahuatl language, meaning Cēmpoal "twenty" and ā (tl), which means "water", "twenty waters" perhaps because that city had a large amount of irrigation canals and aqueducts that provided the vital liquid to the many gardens and fields surrounding farmland. The site was mainly inhabited by totonacas, but also by Chinantec and Zapotec.
The city was originally settled at least 1,500 years before the arrival of the Spaniards and there is evidence of Olmec influence. The Pre-classic city was built on mounds to protect it from flooding.
Zempoala was the Totonac capital and it was the largest city in the Gulf of Mexico. At its peak, it had a population of between 25,000 and 30,000 people, and it was one of the most important Totonac settlements during the Post-classic period.