Atrial fibrillation is the most common arrhythmia in clinical practice and is associated with significant mortality and morbidity due to stroke. Echocardiography plays a critical role in defining the clinical context of the arrhythmia and guiding management. Transoesophageal echocardiography is used to exclude intracardiac thrombus to facilitate early cardioversion. Emerging technologies such as catheter ablation and left atrial appendage occlusion have expanded the role of echocardiography such that it is essential to achieve a high standard of cardiac imaging to optimize patient outcomes.