Background: Catheter ablation (CA) combined with left atrial appendage closure (LAAC) for non-valvular atrial fibrillation (NVAF) has become a hot topic in clinical research in recent years. Aims: This study aimed to investigated the safety and effect of CA combined with LAAC for NVAF. Methods: 150 patients diagnosed with NVAF who received CA combined with LAAC (combined group) in Shanghai Changhai Hospital from October 2020 to December 2021 were retrospectively included. Patients who underwent CA-Only (CA-only group, n=150) were selected using propensity score matching (PSM) in a 1:1 ratio. Results: At one-year follow-up, no significant differences in procedure-related complications（1.33% vs 1.33%,P=1.000）and the incidence of stroke（1.33% vs 1.33 %,P=1.000）were found. The success rate between the combined procedure and the CA-only procedure (persistent AF: 62.5% vs 68.8%, P=0.839; paroxysmal AF: 73.8% vs 76.2%, P=0.775) were similar. Furthermore, there was a significant difference in the incidence of heart failure with preserved ejection fraction (HFpEF) before and after procedure (combined group: 32% vs 18.67%,P=0.049; CA-only group: 18.7% vs 5.3%,P=0.024). Multivariate Logistic regression demonstrated longer short diameter of the LAA orifice (OR=1.196, P=0.049) might be a risk factor for residual leakage around the LAA occluder. Conclusion: The combined procedure was feasible, safe and effective in NVAF patients with a high risk for stroke. Longer short diameter of the LAA orifice might be a risk factor for leakage around the LAA occluder.