Their political influence in Ottoman Syria began in the 18th century when members of the family administered Maarrat al-Nu'man and Hama.

[6] The Al-Azm's began to emerge as a major influence in the region when Ibrahim al-'Azm, "a rural notable possibly of Turkish stock",[4] went to Ma'arrat al-Nu'man to restore order in the mid-seventeenth century.

In fact, there is no doubt, however, that to eighteenth century local annalists and European observers the ‘Aẓms were known as a family of Arab (Bedouin) origin...

It may very well be that the latter view [being of Turkish stock] is a mistaken conclusion based on the family's long residence in the province of Konya.

[12] Ismail Pasha, who later became wāli (governor) of Tripoli, was transferred to Damascus in 1725 at the request of the mufti, after fighting between different factions of janissaries prevented the Hajj caravan from departing on time.

He was succeeded by his nephew As'ad Pasha al-Azm who reigned between 1743 and 1757, and was considered the greatest governor of Damascus in Ottoman times.

[13] Despite As'ad Pasha's ability to ensure the security of the pilgrim caravan, the new Ottoman authorities in Istanbul deposed him in 1757 after fourteen years of governance.

In addition, the Kizlar Agha of Istanbul disliked al-Azm for apparently not taking good care of him when he passed through Damascus on the pilgrim caravan.

[16] Al-Azm's era brought a building boom to Damascus where dozens of baths, khans, schools and souqs were built, many of which still remain today.

Family members were using the name Azmzade in the nineteenth century,[18] in reference to the Azm clan with the zade being an addition indicating nobility.