Oceania Football President David Chung says Patel has taken Fiji football to new heights during his first term and he now has the opportunity to build on that success.
During Patel's four-year term Fiji qualfied for the 2015 Under 20 World Cup in New Zealand, where they created history by beating Honduras.
The Fiji Under 23 team also won the Oceania Olympic qualifying tournament in July and will represent the region in Rio next year.
Patel claimed 37 votes, well clear of his only challenger, former Lautoka president Shalendra Prasad, who picked up 16.
Tarunesh Reddy earned 83 per cent to retain the vice-president west post, Yogeshwar Singh was re-elected to a vice-president position, while Labasa businessman Edwin Chand won the vice-president north seat after standing unopposed.