The left atrial appendage (LAA) is a prominent source of cardioembolic stroke in patients with nonvalvular atrial fibrillation (AF). While systemic anticoagulation is the common therapeutic choice, these medications carry many contraindications and possible complications. Epicardial and endovascular techniques for occlusion of LAA have been explored and early clinical data is accumulating. In the coming years, this data will help guide the management of AF patients at risk of bleeding as well as potentially become first-line therapy to reduce the risk of thromboembolic stroke. The purpose of this article is to review current endovascular and epicardial catheter based LAA occlusion devices and the clinical data supporting their use.