The 2024 Chinese Expert Consensus Guidelines on the Diagnosis and Treatment of Atrial Fibrillation (AF) in the Elderly, endorsed by the Geriatric Society of Chinese Medical Association and the Chinese Society of Geriatric Health Medicine, provide updated recommendations for managing AF in elderly patients. The guidelines emphasize the importance of screening, geriatric comprehensive assessment, and the use of the Atrial Fibrillation Better Care (ABC) pathway for elderly patients. Key recommendations include the use of smart technology for AF screening, optimal anticoagulation, and individualized management based on stroke and bleeding risk. The guidelines highlight the increased risk of AF and stroke in the elderly population, with a higher prevalence of comorbidities, leading to complex clinical presentations. The CHA2DS2-VASc score is recommended for stroke risk assessment, while the HAS-BLED score is used for bleeding risk. The guidelines also emphasize the importance of anticoagulation in high-risk patients, with a preference for NOACs over warfarin. For patients with AF and comorbidities, lifestyle modifications and appropriate drug management are recommended. The guidelines also address the management of AF in patients with cardiovascular diseases, stroke, cancer, and frailty, emphasizing the need for individualized care and regular monitoring. The guidelines provide recommendations for periprocedural and perioperative management of AF in elderly patients, considering the risk of bleeding and the type of procedure. Overall, the guidelines aim to improve clinical outcomes and reduce the burden of AF in the elderly population through comprehensive, individualized care.The 2024 Chinese Expert Consensus Guidelines on the Diagnosis and Treatment of Atrial Fibrillation (AF) in the Elderly, endorsed by the Geriatric Society of Chinese Medical Association and the Chinese Society of Geriatric Health Medicine, provide updated recommendations for managing AF in elderly patients. The guidelines emphasize the importance of screening, geriatric comprehensive assessment, and the use of the Atrial Fibrillation Better Care (ABC) pathway for elderly patients. Key recommendations include the use of smart technology for AF screening, optimal anticoagulation, and individualized management based on stroke and bleeding risk. The guidelines highlight the increased risk of AF and stroke in the elderly population, with a higher prevalence of comorbidities, leading to complex clinical presentations. The CHA2DS2-VASc score is recommended for stroke risk assessment, while the HAS-BLED score is used for bleeding risk. The guidelines also emphasize the importance of anticoagulation in high-risk patients, with a preference for NOACs over warfarin. For patients with AF and comorbidities, lifestyle modifications and appropriate drug management are recommended. The guidelines also address the management of AF in patients with cardiovascular diseases, stroke, cancer, and frailty, emphasizing the need for individualized care and regular monitoring. The guidelines provide recommendations for periprocedural and perioperative management of AF in elderly patients, considering the risk of bleeding and the type of procedure. Overall, the guidelines aim to improve clinical outcomes and reduce the burden of AF in the elderly population through comprehensive, individualized care.