Atrial fibrillation is the most common sustained arrhythmia, and a significant cause of cardiovascular morbidity and mortality throughout the world. It affects over 33 million people, in terms of great symptomatic burden and increased risk of thromboembolic complications, mainly stroke. These are the two aspects that guide a structured and interdisciplinary approach to treatment of atrial fibrillation, starting from its first onset. Accordingly, in acute management of this arrhythmia, a decision must be made on the need and the means of cardioversion, having in mind hemodynamic stability of the patient and possible requirements for anticoagulation. Oral anticoagulant therapy is also an essential strategy for long-term management of atrial fibrillation, on account of considerably improved outcomes of the disease. In this regard, there is a choice between vitamin K antagonists and novel anticoagulants, which depends on a carefull assessment of the risks and benefits of each option. Subsequent approach to atrial fibrillation treatment is aimed at reducing or eliminating patient's symptoms, deciding between two main strategies, rate control and rhythm control. The final decision on the strategy of atrial fibrillation management should be based on recent scientific knowledge, but also reached individually: taking into consideration the characteristics of the patient, advantages and disadvantages of each therapy.