Atrial fibrillation is the most frequently occurring supraventricular arrhythmia in patients presenting with acute myocardial infarction. It is associated with worse outcomes when it coexists with acute myocardial infarction and results in increased morbidity and mortality. Both conditions are closely related to each other and share similar pathophysiological pathways. The management of atrial fibrillation in patients with acute myocardial infarction is challenging since triple antithrombotic therapy is indicated, but this results in a markedly increased risk of bleeding events and mortality. This review addresses the interactions between both conditions including common risk factors, possible mechanisms through which acute myocardial infarction contributes to development of atrial fibrillation and vice versa, and the problem of using anticoagulation in the management of these patients