ABSTRACT Objective According to the results of echocardiography before, during and after percutaneous left atrial appendage (LAAC) in patients with non-valvular atrial fibrillation, the complications of LAAC and the changes in cardiac chamber size and cardiac function, to evaluate the value of echocardiography in LAAC. Methods Preoperative, intraoperative, and postoperative echocardiography (including transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE)) of 205 LAAC performed between August 2014 and July 2018 in our hospital. The images and data were retrospectively analyzed to summarize the occurrence of complications in patients. The end systolic left atrial anteroposterior diameter (LAD)、left ventricular end-diastolic diameter (LVDd), right atrial transverse diameter (RAT), right ventricular internal diameter (RVD), left ventricular ejection fraction (LVEF), left ventricular shortening score (LVFS), end diastolic volume (EDV) and stroke volume (SV) were collected and analyzed the difference between the corresponding parameters before and 48 hours after surgery, 3 to 6 months after surgery, and 1 year after surgery. Results Echocardiography showed successful completion of LAAC in 202 patients (98.5%, 202/205), postoperative occluder-related thrombosis (DRT) in 17 patients (8.4%, 17/202), and pericardial effusion in 4 patients (2.0%, 4/202), 29 cases (14.4%, 29/202, both <5mm) had residual shunt around the occluder. No occluder detachment and displacement occurred in all patients. Compared with preoperative, LVEF, LVFS and SV increased slightly at 48 hours after operation, the difference was statistically significant (P<0.05). LAD, RAT, RVD, LVDd, LVEF, LVFS, EDV and SV was not significantly different from those before surgery (P>0.05) at 3 to 6 months after operation and 1 year after operation. Conclusions LAAC as a means of preventing thromboembolism in patients with non-valvular atrial fibrillation is safe, the incidence of postoperative complications is low, and it does not have a significant impact on cardiac size and cardiac function. Echocardiography has important application value as a means of assessing LAAC safety.