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Atrial fibrillation (AF) affects a significant proportion of older individuals, with prevalence rates of 3.8 ​% in those over 60 and 9.0 ​% in those over 80 years old, posing a considerable risk of stroke. Radiofrequency ablation (RFA) has emerged as a popular treatment option. However, RFA is not without risks, with esophageal injury being a notable complication, as illustrated by our case study of a 67-year-old patient who developed an atrial-esophageal fistula post-RFA. Timely diagnosis is imperative due to the rarity and severe consequences such as esophageal perforation. While treatment strategies remain somewhat uncertain, initial stenting has given way to surgical intervention for improved outcomes. Our study emphasizes the critical importance of vigilance, early identification, and a multidisciplinary approach in managing this challenging complication.