Co-occurrence of dextrocardia, a rare congenital heart de-fect, and atrial fibrillation (AF) is unusual. With the ad-vancements in AF-related guidelines, anticoagulation ther-apy has become increasingly important. Lifelong oral an-ticoagulants remain imperative after successful AF abla-tion. Percutaneous left atrial appendage occlusion (LAAO) is an efficacious and secure strategy for preventing AF-related thromboembolic incidents, thereby confirming the progressive suitability of the one-stop approach of AF abla-tion + LAAO. Cryoablation, which is preferred for its short procedural duration and enhanced tolerability, is particu-larly advantageous for older patients with AF, facilitating a streamlined procedure under local anaesthesia. However, the presence of abnormal anatomical structures presents challenges to this technique. This study describes a case of successful cryoablation + LAAO performed under intrac-ardiac echocardiography guidance in an older patient with dextrocardia and AF, providing a reference for the treat-ment of AF in patients with ectopic anatomy.