Atrial fibrillation (AF) is a common arrhythmia. Currently, catheter ablation is one of the effective treatments and has been widely used in clinical practice. Atrial esophageal fistula is a rare complication of AF catheter ablation but is the most dreadful and deadly one. Therefore, to reduce the risk of its occurrence, we need to fully understand it and take active and effective preventive measures. This article reviews its pathogenesis, risk factors, diagnosis and treatment, and summarizes some of the preventive measures that may be effective at present.