 "Al-Qaeda releases video of American kidnapped in Pakistan")
Warren Weinstein, 72, seen wearing a a grey tracksuit, sounded tired as he said he felt "totally abandoned and forgotten".
"It has been more than two years since I was kidnapped by Al-Qaeda while working as a consultant for a US government programme in Pakistan," he said.
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Weinstein, who was kidnapped from his home in Lahore, said he was suffering from a heart ailment and severe asthma.
He came to Pakistan nine years ago and was the country head of J E Austin Associates, a US-based consulting firm. He was working on a development project in the volatile tribal belt bordering Afghanistan.
Al-Qaeda leader Ayman al-Zawahiri said in December 2011 that Weinstein would be freed if Washington stopped air strikes in Pakistan, Afghanistan, Somalia and Yemen.
The 13.02-minute video, uploaded by Washington Post, appeared to be the first proof that Weinstein was alive since another video statement released in September 2012.
The video was sent by Al-Qaeda to journalists who have worked in Afghanistan. It included the yellow logo of As-Sahab, its media production outlet, and was accompanied by a note, purportedly from Weinstein, titled "Letter to Media".
Weinstein said his captors had agreed to arrange for relatives to visit him if the US agrees to a "quid pro quo".
He also addressed Secretary of State John Kerry, telling him his captors have kept him abreast of peace deals that the top US diplomat has sought to broker.
Weinstein said a "first step" towards his release would be taking "action with respect to their people who are being held as prisoners".
"If anyone in the Obama government can understand my predicament it is yourself," he said.
Weinstein asked the media to help him by building public opinion for his release. The three-page hand-written note asked journalists to keep his case in the news to ensure "that I am not forgotten and just become another statistic".