Atrial fibrillation (AF) is a common arrhythmia associated with substantial morbidity and mortality, particularly due to thromboembolic strokes, the prevalence of which is expected to rise over the next few decades. This article reviews the complex mechanisms behind thromboembolism, compares the newer risk stratification models for identifying those at risk for stroke or bleeding, and highlights the potential advantages and disadvantages of available therapies. Newer oral anticoagulants like Dabigatran, Rivoroxaban, and Apixiban are discussed. There is also discussion on non pharmacological therapies such as left atrial appendage ligation and occlusion devices. This article is intended to help clinicians gain a better understanding of available risk stratification tools and therapies available for prevention of stroke in patients with atrial fibrillation.