Atrial fibrillation (AF) is becoming an epidemiologically important syndrome among the developed countries. Although racial differences exist with regard to AF prevalence, it remains unclear whether the AF mortality and morbidity rates exhibit racial differences. Medical treatment and management of AF is aimed at improving the clinical course of AF patients who reside in a particular region; therefore, the AF mortality and morbidity rates should be assessed from both global and local viewpoints. AF is a progressive disease that might be first detected as paroxysmal, persistent, or permanent. The associations between AF progression and AF-related cardiovascular morbidities and those between the cardiovascular morbidity and mortality rates of AF are important matters of discussion, as they reflect the rationale of AF therapy. At present, AF patients have a wide variety of backgrounds, and these analyses would require stratification by risks, which would not be free from racial differences. In this review, the mortality and morbidity rates of Japanese AF patients are reviewed and discussed.  (Circ J 2013; 77: 864–868)