Atrial fibrillation (AF) is a critical risk factor for stroke. Despite secondary prevention with anticoagulant therapy, the annualized risk of stroke recurrence in patients with AF remains substantial, ranging from 3.2% to 6.5%. The traditional CHA2DS2-VASc scoring system, which is based on clinical factors for risk stratification, fails to adequately reflect dynamic cardiac structural remodeling or subclinical cerebrovascular injury. This paper reviews recent advances in neuroimaging (covert brain infarction, cerebral microbleeds and white matter hyperintensities) and echocardiography (left atrial structure, left atrial strain, left atrial appendage morphology, left atrial appendage spontaneous echo contrast and left atrial appendage emptying velocity) for risk assessment of stroke recurrence in patients with atrial fibrillation, which aims to optimize the traditional scoring system for more precise risk stratification.