Heth originally represented a voiceless fricative, either pharyngeal /ħ/, or velar /x/. In Arabic, two corresponding letters were created for both phonemic sounds: unmodified ḥāʾ ح represents /ħ/, while ḫāʾ خ represents /x/.

The Phoenician letter gave rise to the Greek eta Η, Etruscan , Latin H and Cyrillic И. While H is a consonant in the Latin alphabet, the Greek and Cyrillic equivalents represent vowel sounds.