Although pulmonary vein (PV) isolation is the cornerstone for atrial fibrillation (AF) ablation; no data exist comparing the PV anatomy between the AF subtypes directly. We aimed to compare the PV anatomic characteristics between paroxysmal AF (PAF) and persistent AF (PeAF) in a matched population using cardiac computed tomography. A total of 58 patients with PeAF (with cardiac computed tomography before the first AF ablation procedure, absence of valvular disease/previous cardiac intervention), and 58 age-, gender-, and body surface area-matched patients with PAF were evaluated for left atrial (LA) and PV anatomy: ostial area, ovality index, and transverse/frontal angles. In the PeAF versus PAF group, other than a higher LA volume index; the PV ostial areas were significantly larger (between 64 and 101mm2, p <0.001 for all PVs; remaining valid after LA volume index adjustment for left superior PV [LSPV], left inferior PV [LIPV], and right superior PV); the left PVs were less oval (0.7 to 0.11 ovality index decrease, p=0.039 for LSPV; p=0.012 for LIPV); and the LSPV (p=0.019), LIPV (p <0.001), and right inferior PV (p=0.029) were more posteriorly directed; whereas the LSPV (p=0.002) and right superior PV (p=0.043) were more superiorly directed. The incidence of anatomic variations or early branching was not different. This study showed significant anatomic PV differences between patients with PeAF and PAF in terms of PV orientation, ostial size, and ovality. Anticipating such anatomic differences may aid in choosing the adequate catheter design and technology for PeAF ablation.