The management of atrial fibrillation (AF) has undergone tremendous changes over the last 50 years. Once thought as a mere consequence of rheumatic mitral stenosis, AF has surged to become a key clinical-electrocardiographic syndrome, with specific risk factors, a highly variable underlying substrate, and related complications, whose prevention requires an integrated holistic management plan. Throughout this article, we discuss major progresses in the fields of anticoagulation management, rhythm and rate control, and catheter ablation, aiming to provide a balanced oversight of what has been done, and a fresh perspective of what is yet to be accomplished by next generations of clinicians and researchers.