Erian Acosta is wanted in Washington state for two counts of child molestation and one count of child rape.
The three complainants who are now all young women allege the incidents occurred while they were all under the age of 10.
But Acosta asked the court for a judicial review of an August 2012 decision by the federal minister of justice to surrender him to U.S. authorities.
Justice Pamela Kirkpatrick has dismissed the appeal, saying extraditing Acosta to the U.S. where he could face a life sentence would not offend what Canadians consider "fair and just."
Kirkpatrick also says the minister appears to have followed case law, dismissing an argument he didn't balance the relevant circumstances in the case.