Objective To investigate the association between long-term hemodialysis and atrial fibrillation, and to provide evidence-based data for clinical practice. Methods Databases including CNKI, Wanfang Data, and PubMed were searched for observational studies on the association between long-term hemodialysis and atrial fibrillation. After related articles were extracted and quality assessment was performed, RevMan 5.1 software was used to perform the meta-analysis. Results A total of 13 articles were included, involving 8485 patients. There were no significant differences in general data between the two groups in each study. The meta-analysis showed that the incidence rate of atrial fibrillation was 12.0% (95% confidence interval [CI]: 10.5%-13.5%) in patients undergoing hemodialysis. There was a significant increase in the risk of atrial fibrillation in patients undergoing hemodialysis (odds ratio [OR]=0.66, 95%CI:0.59-0.86, P<0.001), and there was a significant increase in the incidence rate of atrial fibrillation in patients undergoing hemodialysis for a relatively long time (OR=1.86, 95%CI:1.18-3.15, P<0.001). The Egger’s linear regression test and the Begg’s funnel plots were used to assess publication bias, with P=0.807 and Pr>|Z|=0.707, respectively, and the funnel plots did not show the presence of publication bias. Conclusion Long-term hemodialysis can increase the incidence rate of atrial fibrillation, and there is an association between long-term hemodialysis and atrial fibrillation.