Object Through the analysis of a series of real clinical data acquired by transesophageal echocardiography (TEE), we know the value of transesophageal echocardiography in the treatment of left atrial appendage and its follow-up. Methods From March 2015 to April 2017 in our hospital diagnosed atrial fibrillation and WATCHMAN left atrial appendage percutaneous closure of patients as the object and through transesophageal echocardiography to observe and record the operation, followed up 45 days, 6 Month occluder effect, including residual shunt, with or without thrombus and occluder compression diameter. Results A total of 243 cases of atrial fibrillation underwent percutaneous balloon occlusion of the left atrial appendage were collected. 241 cases (99.2%) were successfully implanted WATCHMAN occluder. Pericardial tamponade was found in 2 cases (0.83%) and found Thrombosis occurred in 1 patient (0.41%). After 45 days of follow-up, 3 patients (1.36%) had thrombosis, and no significant device-related thrombosis and death occurred at 6 months follow-up. Conclusion The transesophageal echocardiography played an important role in the WATCHMAN left atrial appendage occlusion and postoperative follow-up. The evaluation of the surgical effect and postoperative complications is objective, timely and worth recommending clinical application.