Atrial Fibrillation (AF) poses a significant burden to patients as well as the healthcare system. It can be a complex diagnosis and requires a holistic approach to treatment. Every patient with AF should be evaluated for the need for anticoagulation therapy to prevent systemic embolization. In those that require long-term anticoagulation, a novel oral anticoagulation agent (NOAC) has become the drug of choice. In recent years there have been huge developments in the field of anticoagulation in AF with the presence of the various NOACs on the market. However, there remains uncertainty around prescribing in obese patients.