Percutaneous left atrial appendage (LAA) closure has evolved significantly since its inception with the PLAATO device in 2001. Initially developed as an alternative to oral anticoagulation in patients with atrial fibrillation at high bleeding risk, LAA closure has shown efficacy in reducing stroke and cardiovascular death. Advances in device design and procedural techniques have improved safety and broadened applicability. This chapter provides a comprehensive overview of current LAA closure technologies, including endocardial (Watchman FLX, Amulet, LAmbre, Omega), epicardial (Lariat), and hybrid approaches. Key procedural steps such as transseptal puncture, device selection, and deployment techniques are reviewed in detail, with an emphasis on imaging guidance and anatomical considerations. Postprocedural management and anticoagulation strategies are also discussed. Emerging technologies continue to address anatomical challenges and enhance procedural success, making LAA closure a safe and increasingly utilized option in stroke prevention.