Lawyers for Venezuela's Rafael Esquivel, 69, had asked the Federal Court's appeals chamber to release him.
He has been in custody since a dawn raid in Zurich on May 27 nabbed him and six other football executives on U.S. arrest warrants, throwing the governing body of global football into turmoil.
"The court held that there was a risk that the appellant would abscond if released. The arguments put forward in support of his release, such as his advanced age and poor state of health, were not regarded as sufficient to counter the risk of absconding," the court said in a statement on Monday.
The court did not identify him by name but said he had headed Venezuela's football association and was a member of the executive committee of the South American Football Confederation. A law enforcement source confirmed it was Esquivel.
Esquivel, who the court said denies wrongdoing, is fighting efforts to extradite him to the United States. U.S. prosecutors accuse 14 football officials and sports marketing executives of bribery, money laundering and wire fraud charges involving more than $150 million in payments.
Esquivel has been in hospital since Sept. 28 for unspecified tests, Switzerland's Federal Office of Justice said.
The Swiss court ruled that Esquivel posed a danger of fleeing and had access to nearly $1 million. It rejected his request to be placed under surveillance via electronic monitoring.
Esquivel had argued that he had lost large amounts of weight and faced a psychological burden from incarceration. U.S. authorities had frozen around $3 million (£2 million) of his wealth, making it hard for the father of six to support his family.
The Spanish-Venezuelan dual citizen had a diplomatic passport from Venezuela, where he lived with his wife and two children, the court said.
(Reporting by Michael Shields and Joshua Franklin; editing by John Stonestreet)
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