Atrial fibrillation (AF) is a common arrhythmia with increased risks of stroke and other cardiovascular complications. This research examined the long-term outcomes of anticoagulation therapy in AF patients, focusing on its benefits for stroke reduction, bleeding hazards, and survival rates. Researchers conducted an extensive literature search that combined PubMed, Scopus, Web of Science, and Google Scholar to retrieve publications from 2015 to 2025. The search focused on keywords related to anticoagulation therapy and its connection to atrial fibrillation, stroke prevention, as well as both long-term outcomes and bleeding risks. The data extraction process was performed by two independent reviewers, while the assessment of study quality relied on the Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool. The evaluation of evidence quality followed the GRADE approach. A total of 12 studies were included in this review after full screening. Direct oral anticoagulants (DOACs) exhibited either matching or superior stroke prevention performance compared to warfarin while showing lower major bleeding occurrence according to existing research findings. Studies demonstrated that patients receiving DOACs had longer survival rates when examining death rates. The review demonstrated that anticoagulation medication shows strong clinical results as a treatment strategy for prolonged atrial fibrillation cases. Further research must expand with prolonged follow-up examinations to establish data on the safety and effectiveness of DOACs compared to warfarin and to create better guidelines for the long-term anticoagulation treatment of AF patients.