The structure of the plasma membrane affects its function. Changes in membrane fluidity with concomitant effects on membrane protein activities and cellular communication often accompany the transition from a healthy to a diseased state. Although deliberate modulation of membrane fluidity with drugs has not been exploited to date, the latest data suggest the "druggability" of the membrane. Azelaic acid esters (azelates) modulate plasma membrane fluidity and exhibit a broad range of immunomodulatory effects in vitro and in vivo. Azelates represent a new class of drugs, membrane active immunomodulators (MAIMs), which use the entire plasma membrane as the target, altering the dynamics of an innate feedback regulated homeostatic system, adaptive membrane fluidity modulation (AMFM). A review of the literature data spanning >200 years supports the notion that molecules in the MAIMs category including known drugs do exert immunomodulatory effects that have been either neglected or dismissed as off-target effects.A literature search was conducted using PUBMED, MEDLINE, and Library of Congress databases to capture peer-reviewed research articles (including reviews and metaanalyses), published through August 27, 2021, with the earliest record dating from 1801. The search terms included "plasma membrane" AND "fluidity" OR "plasticity" OR "rigidity". Secondary searches combined keywords consisting of individual chemical entities listed in this manuscript (for example, cholesterol, ethanol, turpentine) and physiological conditions (for example pain, fever, disease). The collected abstracts and/or full papers were surveyed by both authors in order to confirm article relevancy to the topic.