El-Hage interrupted his schooling to travel to Afghanistan via Pakistan, although his lifelong physical disability prevented any direct participation in the fighting against the USSR, he instead worked for a Saudi charity called the Muslim World League. He was reportedly under Abdullah Yusuf Azzam, an important figure in the early history of al-Qaeda. El-Hage returned to his university in January 1985, graduating in 1986. He married an 18-year-old American Muslim named April and relocated to Arizona. There he held several low-wage jobs, including city custodian. He became a naturalized citizen of the United States in 1989.