General David Petraeus, commander of the NATO-led force in the Afghanistan war, credited Islamabad with battling insurgents elsewhere but said the campaign needed to move to North Waziristan.
"The fact is that it's hugely important that there's a campaign in northern Waziristan that is putting enormous pressure on the al Qaeda sanctuaries there," Petraeus said at a conference in Washington.
US officials have long urged Pakistan to crack down on militants in North Waziristan but the country's military commanders have said their forces are already stretched fighting the insurgents in nearby areas.
"They have lost thousands of soldiers and thousands of civilians in a very impressive counter insurgency campaign to clear Swat Valley and the other areas" in Khyber and South Waziristan, Petraeus said.
The CIA has carried out a long-running drone bombing campaign in North Waziristan, with 17 of 20 strikes targeting militants in the area so far this year, according to a tally by the New America Foundation.
A US strike by unmanned aircraft killed at least 38 people this week in North Waziristan, prompting outrage and protests across the country on Friday.
Petraeus referred to Pakistan's concerns about preserving its influence in neighboring Afghanistan.
"It is understandable that Pakistan wants to have reassurance that the country to its west ...is not a proxy for India, that it will not be just peaceful and stable but also will be a friend of Pakistan," he said.
"Among the most important ways to influence what happens overtime in Pakistan is to continue to make progress in Afghanistan," he added.
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