The video of Warren Weinstein, 70, was posted on militant websites Sunday.
"My life is in your hands, Mr. President. If you accept the demands, I live. If you don't accept the demands, then I die. It's important that you accept the demands and act quickly and don't delay," he says.
This was the first time Weinstein was seen since his abduction last August when eight armed men broke into his home in Lahore, Pakistan. Weinstein was a former Peace Corps and U.S. aid official who worked in Pakistan for a private company dealing with international aid issues.
"I've done a lot of service for my country, and I would hope that my country will now look after me and take care of me and meet the demands of the mujahedeen," Weinstein said.
Weinstein doesn't explicitly say what those demands are, but al Qaeda leader Ayman al-Zawahiri has said in the past that they will release the American if the U.S. releases the accused terrorists held at Guantanamo Bay, Cuba, and ends their drone attacks.
On Sunday, the top al Qaeda leader in Yemen was killed by a missile from an unmanned drone.
"They know we're not going to honor that clearly, but it goes back to the whole big picture ... it's really all about propaganda," said former FBI agent Brad Garrett.
The hostage tape was released just days after the arraignment of accused 9/11 mastermind Khalid Sheik Mohammed and four others started at Guantanamo Bay. The five accused terrorists refused to answer the judge's questions, and interrupted the court room with spontaneous prayers and shouts.
One of the defense attorneys said the outbursts were meant as a protest for the torture they say they've endured in detention.
It's unclear when the video of Weinstein was recorded. So far, the White House has not commented on the video or al Qaeda's demands.