Abstract: Objective To investigate the evaluation and clinical significance of esophageal echocardiography on left auricular volume and function changes in patients with atrial fibrillation. Methods A total of 60 patients with atrial fibrillation admitted to Jinhua Central Hospital from May 2018 to May 2019 who underwent transesophageal echocardiography were selected as study group. Sixty patients with other heart diseases without atrial fibrillation who underwent transesophageal echocardiography in our hospital during the same period were selected as control group. Transesophageal echocardiography was performed in the same manner in two groups. Results The level of LAD in the study group(41.8±5.6) mm was significantly higher than that in the control group(30.2±4.1) mm(t=12.950, P=0.001). The weight distribution of SEC in the control group was significantly better than that in the study group(all P<0.05). In the control group, MA level was(2.8±1.3) cm, MD level was(3.0±0.4) cm, ESV level was(1.6±0.7) mL, EDV level was(3.3±1.1) mL, EF level was(59.1±15.2)% and PEV level was(67.5±15.9) cm/s. In the study group, MA level was(5.1±2.0) cm, MD level was(3.8±0.6) cm, ESV level was(4.1±2.6) mL, EDV level was(6.3±2.2) mL, EF level was(40.2±13.0)%, PEV level was(44.8±12.7) cm/s. The levels of MA, MD, ESV and EDV in the study group were significantly higher than those in the control group(all P<0.05). The EF and PEV levels in the study group were significantly lower than those in the control group(all P<0.05). Conclusion Transesophageal echocardiography can be used to observe the changes of left auricular function and volume in patients with atrial fibrillation, and more clearly display the physiological structure of the patient's left auricular.