Atrial fibrillation is one of the most common supraventricular arrhythmias. It has multiple etiologies, some of which include advanced age, hypertension, valvular heart disease, hyperthyroidism, sleep apnea, ischemic heart disease, cardiomyopathy, and certain medications. Herein, we will discuss a case of extensive atrial fibrosis in a 57-year-old male with recalcitrant atrial fibrillation, the significant role extensive atrial fibrosis plays in the recurrence of atrial fibrillation, a brief pathophysiologic interplay between both pathologies based on current literature and research, and various imaging modalities and treatment options utilized in these cases. Likewise, we will also outline some challenges faced or worth keeping in mind when using the various imaging modalities pertaining to the above subject matter.