During the Soviet–Afghan War el-Hage traveled to Pakistan to work for a Saudi charity, returning to the US in 1985. He married 18 year old April Ray, an American citizen who had recently converted to Islam, gaining American citizenship in 1989. Struggling financially, he decided to move his family to Quetta, Pakistan, but returned to run the Al Kifah Refugee Center in Brooklyn after the death of Mustafa Shalabi. While running the al-Kifah Refugee Center he met some of the extremists involved in the 1993 World Trade Center bombing. At the time of their trial, he was in Sudan working as a secretary for Osama Bin Laden. In 1996 and 1997, after Bin Laden left Sudan for Afghanistan, el Hage worked in Nairobi, Kenya. Under the pretense of doing charity work, he organized the al-Qaeda network that planned the carried out the embassy bombing in Nairobi.