Atrial fibrillation (AF) is one of the more prevalent arrhythmias in clinical practice. Its initiation and maintenance are closely associated with the dysregulation of the cardiac autonomic nervous system. The imbalance between sympathetic and parasympathetic regulation, combined with the abnormal firing of ganglionated plexi (GP) promotes atrial electrical and structural remodeling. These pathological processes exacerbate atrial ectopic triggering and reentrant activities, shorten the atrial effective refractory period, and increase myocardial spatial heterogeneity, thereby serving as critical mechanisms underlying the genesis and perpetuation of AF. Consequently, cardiac autonomic modulation techniques, which aim to suppress sympathetic activity and enhance parasympathetic tone, have emerged as promising therapeutic strategies. These interventions primarily include GP ablation, epicardial botulinum toxin injection, low-level vagus nerve stimulation, renal denervation, and stellate ganglion ablation. This article reviews the roles and strategies of cardiac autonomic modulation in the management of AF.