The aim of this study is to investigate the expression level of macrophage inflammatory protein-1α (MIP-1α) in atrial fibrillation patients and its correlation with the risk of left atrial remodeling. A total of 64 atrial fibrillation patients admitted to our hospital from April 2020 to December 2021 were prospectively selected as the case group and 61 healthy subjects who received physical examination during the same period were selected as the control group. Serum MIP-1α level was determined by a double-antibody sandwich enzyme-linked immunosorbent assay. Serum MIP-1α expression levels were compared between the case and the control groups. The case group was divided into high-level and low-level groups according to the serum MIP-1α median. Simultaneously, the sociodemographic data, clinical data, and left atrial remodeling indexes of the patients were collected in the case group. The Pearson correlation analysis was applied to analyze the correlation between the serum MIP-1α level and the risk of left atrial remodeling in patients with atrial fibrillation. The serum MIP-1α level was significantly higher in the case group than that in the control group (
P
<
0.05
), high-level group (≥2.14 pg/mL, 32 cases), and low-level group (<2.14 pg/mL, 32 cases). There were significant differences in the anteroposterior diameter, upper and lower diameter, left and right diameter of the left atrium, left atrial volume, volume index, left atrial global ejection fraction, and sphericity between the low-level and high-level groups (
P
<
0.05
). The Pearson correlation analysis showed that serum MIP-1α level was positively correlated with the left atrial anteroposterior diameter (r = 0.745), left atrial left and right diameter (r = 0.759), left atrial upper and lower diameter (r = 0.810), left atrial volume (r = 0.837), left atrial volume index (r = 0.813), and left atrial sphericity (r = 0.785) but negatively correlated with the left atrial global ejection fraction (r = -0.731) (
P
<
0.05
). The expression level of serum MIP-1α is high in atrial fibrillation patients and is associated with the risk of left atrial remodeling.