Atrial fibrillation (AFib) after coronary artery bypass graft surgery (CABG) is the most common serious rhythm problem. It is more common in older patients who undergo first or repeat operations. AFib increases surgical morbidity, complicates the hospital stay, lengthens hospitalization, and increases total medical costs. Several approaches to manage AFib after CABG have been advocated: prophylactic drug therapy, anticoagulation, ventricular rate control, cardioversion, and maintenance of sinus rhythm. For each of these different approaches several valid treatment methods exist. Recent trials have confirmed the validity of several of the established approaches and have also uncovered new methods to manage and treat post-CABG AFib. This article provides an overview of the problem, reviews data on therapeutic treatment options, and provides a schematic management approach for post-CABG patients at risk for AFib.