Thalidomide (α-N-[phthalimido] glutarimide, C13 H10 N2 O4), is a glutamic acid derivative initially introduced as a sedative hypnotic nearly forty years ago. It was withdrawn following numerous reports linking it to a characteristic pattern of congenital abnormalities in babies born to mothers who used the drug for morning sickness. It has gradually been re-introduced into clinical practice over the past two decades, albeit under strict regulation, since it was found to be broad spectrum of anti-cancer activity. Anti-tumor activity of thalidomide may be related to a number of known properties, including anti-tumor necrosis factor (TNF)-α and T-cell co-stimulatory and anti-angiogenic activities. Nanoemulsions of thalidomide were prepared in the form of intravenous injection for the treatment of cancer. The therapeutic potential of thalidomide provided motivation to develop more effective derivatives with considerably reduced toxicity. There are two types of thalidomide's immunomodulatory (IMiDs) analogs are lenalidomide and pomalidomide represent a novel class of compounds with numerous effects on the immune system. These analogs are thought to mediate the anticancer and anti-inflammatory effects observed in humans. Thalidomide is currently approved for the treatment of dermal reaction to leprosy and is currently in phase III trials for multiple myeloma (MM). IMiDs inhibit the cytokine's tumor necrosis factor-α (TNF-α), interleukins (IL) 1 α, 6, 12, and granulocyte macrophage-colony stimulating factor (GM-CSF). The repression of the tumor necrosis factor-a (TNF-a) expression is the crucial factor of many of the anti-inflammatory properties of thalidomide.