Crestone ("crestón") is a Spanish word with many meanings from which to choose: cockscomb, large crest, or outcropping of ore. The jagged silhouette presented by both this and Crestone Peak suggest that they were named for a rough resemblance to a cockscomb. Early names of which this peak and its neighbors were known included "Trios Tetons" or Three Tetons, "The Needles," and "Spanish Crags."
Crestone Needle was first climbed only a short time before the last hold-out, Crestone Peak. Each year a few experts are able to climb the two of them together.