Atrial esophageal fistula (AEF) is a rare but life-threatening complication of atrial fibrillation (AF) ablation, linked to thermal injuries by conventional radiofrequency (RF) and cryo-balloon (CB) ablation techniques. AEF risk can be mitigated by considering several measures such as monitoring esophageal luminal temperature, tailored power settings of ablation technique, mechanical displacement of esophagus, esophageal cooling, and alternative ablative techniques and energy sources. We review the current knowledge regarding AEF and esophageal thermal injuries as well as discussing the current research regarding a novel non-thermal, myocardial tissue-selective modality known as pulsed-field ablation (PFA) which may mitigate such risks. By inducing irreversible electroporation, PFA reduces thermal injury and demonstrates improved safety profiles, as evidenced by recent meta-analyses reporting zero esophageal injury and AEF cases. Additionally, the integration of 3D mapping systems with PFA has enhanced its procedural precision and accuracy as well as the ability to utilize real-time imaging. Despite these advances, challenges such as standardizing anesthesia protocols and tailoring energy settings remain. Our review suggests that PFA may reduce the risk of AEF from catheter ablation of AF. Although PFA may reduce the risk of any aberrant thermal injuries, studies report increased incidences of coronary vasospasms and hemolysis. Future long-term outcome studies should provide more information on possible adverse outcomes with PFA as well as tailoring the power settings of PFA.