Atrial fibrillation (AF) is becoming increasingly common in an ageing population. Much of the morbidity and mortality in AF is due to stroke and thromboembolism. Awareness of stroke risk and the need for prevention is well recognized but is far from satisfactory in the real world. Despite refinements in the risk stratification over the years, there is an unmet need for appropriate thromboprophylaxis due to the underuse of oral anticoagulation. Primary care physicians and generalists bear the burden of managing AF. Coordinated multidisciplinary efforts by cardiologists, primary care physicians, and neurologists may be needed to meet the increasing challenge of stroke prevention and rhythm management in AF. This article discusses the potential the role of the cardiologist in the management of stroke prevention in patients with AF.