Atrial fibrillation (AF) is the most common cardiac arrhythmia and is known to be associated with stroke, dementia, heart failure, and increased mortality. For patients with drug-refractory AF, ablation therapy using surgical or catheter-based techniques is recommended. In the evolution of surgical AF treatment, the Maze Ⅲ procedure marked a significant milestone as the first surgical approach to achieve a high success rate in restoring sinus rhythm. However, due to its technical complexity and demanding requirements, researchers have extensively modified the technique using innovative approaches, leading to the development of new surgical ablation methods, including the Maze Ⅳ procedure, minimally invasive Maze Ⅳ surgery, and hybrid ablation techniques. This review focuses on these surgical treatment strategies and discusses the latest research advancements in the field.