Recent progress in image-controlled, localized proton MR spectroscopy offers a non-invasive means of gaining unique insights into brain metabolism in man. Combined studies with MR imaging can be performed within about 1 h. Results obtained in healthy subjects provide the basis for reliable identification and quantification of metabolite concentrations in the CNS and allow determination of their regional variability and age dependence. Clinical applications include infarcts, tumors, and neurodegenerative diseases, and also metabolic disturbances resulting from diseases of the internal organs, such as diabetes mellitus or liver cirrhosis.