This meta-analysis compares the efficacy and safety of pulsed-field ablation (PFA) and thermal ablation (TA) for treating atrial fibrillation (AF). The study included 18 studies involving 4998 patients, with PFA used in 35.2% of cases. PFA was associated with shorter procedure times but longer fluoroscopy times compared to TA. PFA showed better first-pass isolation rates and lower treatment failure rates, but higher rates of pericardial tamponade and higher levels of high-sensitivity troponin. Subgroup analyses revealed no significant differences in efficacy and safety between PFA and TA in patients with paroxysmal atrial fibrillation (PAF) or persistent atrial fibrillation (PersAF). Cryoballoon ablation (CB) was associated with higher (peri-)esophageal injuries but shorter procedural times compared to radiofrequency ablation (RF). The study concludes that PFA is a faster and more efficient option for AF treatment, but it has important safety differences from TA, requiring further research to assess myocardium-related complications and fluoroscopy exposure.This meta-analysis compares the efficacy and safety of pulsed-field ablation (PFA) and thermal ablation (TA) for treating atrial fibrillation (AF). The study included 18 studies involving 4998 patients, with PFA used in 35.2% of cases. PFA was associated with shorter procedure times but longer fluoroscopy times compared to TA. PFA showed better first-pass isolation rates and lower treatment failure rates, but higher rates of pericardial tamponade and higher levels of high-sensitivity troponin. Subgroup analyses revealed no significant differences in efficacy and safety between PFA and TA in patients with paroxysmal atrial fibrillation (PAF) or persistent atrial fibrillation (PersAF). Cryoballoon ablation (CB) was associated with higher (peri-)esophageal injuries but shorter procedural times compared to radiofrequency ablation (RF). The study concludes that PFA is a faster and more efficient option for AF treatment, but it has important safety differences from TA, requiring further research to assess myocardium-related complications and fluoroscopy exposure.