Over 20 years of research based upon application of experimental models of inflammation and tissue injury have revealed exquisite controlling functions for melanocortin hormones and, subsequently, their synthetic derivatives. More recent discoveries have shed light on the receptor targets responsible for these effects, leading to what could be the next step-change for this line of research, the development of novel therapeutics for the control of human inflammatory pathologies. Here we review some of this work with particular emphasis on more recent studies that have substantiated the activities of melanocortin peptides to reveal important regulatory functions for their receptors in vascular inflammation and disease models. Moreover, we summarise the drug discovery activities (for what is published knowledge) attempting to capitalise on this wealth of research on melanocortins, though we should not forget the successful employment of ACTH to treat human gouty arthritis. Altogether, this chapter would corroborate and flare the enthusiasm for this line of research, as we are confident that the right times might have arrived to develop novel anti-arthritic and tissue-protective compounds that will be acting by mimicking the way our endogenous melanocortins would act to exert their homeostatic and check-point functions.