Background: Atrial Fibrillation (AF) is an abnormal heart rhythm characterized by the rapid and irregular beating of the atrial chambers of the heart. High blood pressure and valvular heart disease are the most common alterable risk factors for AF. The aim of this study was to evaluate the clinical profile and echocardiographic features in patients of AF. Methods: A total of 110 patients aged above 18 years and diagnosed with AF were enrolled in the study in MGM Medical College & LSK Hospital, KIshanganj, Bihar. These patients underwent a detailed general physical and systemic examination. Relevant biochemical investigations, chest X-ray and echocardiography were done in all patients. Results: The mean age of the study group was found to be 62.8 years with a male preponderance. Hypertension was the most common cause overall contributing to 28.79 % followed by rheumatic heart disease (21.2 %). A total of 36 patients exhibited LA size greater than 5cm and LA clot was observed in 4% of patients on transthoracic echocardiography. Conclusion: Hypertension was seen to be a major risk factor for AF and hence it needs to be detected and managed early. Lifestyle modifications with diet and exercise can help in reducing the prevalence of hypertension and thus the risk of developing AF.